- 


LIBRARY 


fj  E.C.GARDNER. 


-  R    F~~*. 

Read  ,  and  then  return. 


V 


ON 


MILITARY  AND  CAMP  HOSPITALS, 


HEALTH  OF  TROOPS  IN  THE  FIELD. 


THE    RESULTS   OP   A  COMMISSION   TO   INSPECT   THE  SANITARY  ARRANGE- 
MENTS  OP   THE   FRENCH   ARMY,    AND   INCIDENTALLY    OP 
OTHER   ARMIES   IX    THE    CRIMEAN    WAR. 


BY 


L.    BAUDENS, 


INSPECTOR   AND   MEMBER   OF  THE     COUNCIL     OF    HEALTH   OF  TIIK   FRENCH    ARMIES, 

FORMERLY     SURGEON-IN-CHIEF,     AND     FIRST    PROFESSOR,    OF    THE 

PERFECTING   SCHOOL   OF  VAL  DE-GRACE,   ETC.,   ETC. 


mtb  ^nnota&b  bn 
FRANKLIN  B.  HOUGH,  M.D., 

LATE   AN   INSPECTOR    OF   THE    IT.    S.    SANITARY   COMMISSION. 


NEW  YOEK: 
BAILLlfiRE  BROTHERS,  440  BROADWAY. 


LONDON : 

H.      BAILLIERE, 
REGENT  ST. 

MELBOURNE: 
F.    BAILLIERE, 

COLLINS   ST. 


PARIS  : 

J.   B.   BAILLIERE    BT   FILS 
RUE  HAUTEFEUILLE. 


MADRID  : 

BAILLY-BAILLIBRE, 
CALLE   DEL   PRINCIPE. 


1862. 


BIOLOGY 
UBRARV 


Entered,  according  to  Act  of  Congress,  in  the  year  1862,  l>j 

BAILLIEEE  BROTIIEES, 

In  the  Clerk's  Office  of  the  District  Court  of  the  United  States  for  the  Southern 
District  of  New  York. 


K.   CUAIGHEAD, 

Printer,  Slfreotyper,  anil  Klertrotyper 


tfl,S3,anrfS.5  Ceiif 


ADMINISTRATIVE  AND  MEDICAL  OFFICERS 

OT  TKB 

OIP     THE      TJNITEID      STATES, 

THIS  LITTLE  VOLUME  OF 

3&MfUltS  Of 
8ANITABT  INSPECTION  AND  CONSERVATIVE  SURGERY 

IN  THE 

•  French  Army  of  the  Crimea, 

IS   RESPECTFULLY   DEDICATED 

BY  THE 

translator. 


M234S7 


TRANSLATOR'S   PREFACE. 


THE  acknowledged  value  of  the  experiences  of  the 
French  Army  in  the  Crimean  war,  has  suggested  the 
translation  of  the  present  volume,  with  the  desire  to 
render  the  results  of  the  dearly-bought  lessons  of  that 
campaign  useful  to  the  American  Armies  in  the  present 
war  for  the  preservation  of  our  national  Government. 

It  became  the  painful  duty  of  the  historians  of  the 
Crimean  war  to  record  many  errors  and  oversights, 
resulting  in  a  most  fearful  loss  of  human  life.  When 
these  faults  were  discovered,  their  remedy  was  attempt- 
ed by  the  medical  and  administrative  officers  of  the 
army,  with  as  much  success  as  their  resources  allowed  ; 
and  the  expedients  adopted  for  relief,  in  a  wild  and 
desolate  region,  at  a  great  distance  from  their  supplies, 
are  at  once  suggestive  and  profitable  to  every  person 
who  may  be  concerned  in  the  health  of  armies.  In  the 
translation,  the  French  weights  and  measures  have 
been  mainly  changed  to  their  corresponding  values 
known  and  used  in  the  United  States,  precisely  or 
approximately,  according  to  the  original  intention  of 
the  author.  In  rough  estimates  the  metre  has  been 
called  the  yard,  an  allowance  being  made  when  the 
numbers  were  large ;  but  in  every  case  where  precise 
quantities  are  expressed,  the  rendering  has  been  care- 
fully made,  and  in  some  instances  both  denominations 
have  been  retained. 


Vlll  TRANSLATOR  S    PREFACE. 

Money  has  occasionally  been  allowed  to  remain  in 
francs,  and  decimals  have  been  used  in  expressing  parts 
of  a  given  measure,  as  pounds,  gallons,  and  feet,  instead 
of  the  lower  denominations. 


BIOGRAPHICAL    NOTICE. 


JEAN-BAPTISTE  Louis  BAUDENS,  the  author  of  this  volume, 
was  born  at  Aive  (Pas-de-Calais),  in  1804,  and  received  the 
degree  of  Doctor  of  Medicine  in  Paris,  in  1837,  having  pre- 
viously served  in  the  medical  corps  of  the  French  Army  in 
Algeria.  He  was  employed  successively  in  the  hospitals  of 
Lille,  Strasbourg,  and  Paris,  and  obtained  in  each  the  prizes  in 
Surgery  and  Anatomy.  As  Aide-Major  in  Africa,  he  succeeded 
in  forming  a  hospital  of  instruction  at  Algiers,  where  he  gave 
clinical  lectures.  Upon  his  return  to  France,  his  eminent 
services  in  Africa,  which  had  been  witnessed  by  the  princes  of 
Orleans,  gained  him  rapidly  a  fine  position  in  the  profession,  and 
a  wide  circle  of  beneficent  influence.  He  became  Surgeon-in- 
Chief  of  the  military  hospital  of  Val-de-Grace,  in  Paris,  where 
he  remained  ten  years. 

On  the  25th  of  July,  1855,  he  was  appointed  Medical  Inspec- 
tor to  the  French  Army  in  Corsica,  Italy,  and  the  Crimea,  and 
his  subsequent  history  is  detailed  in  this  volume.  The  intelli- 
gence and  devotion  with  which  he  engaged  in  this  service 
gained  him  the  approbation  of  his  government,  but  cost  him  his 
life.  Returning  to  France,  he  prepared  the  volume  now  given 
to  the  public  in  an  English  dress,  but  the  miasmatic  exposures 
which  he  had  encountered  in  the  camps  and  hospitals  of  Con- 
stantinople and  the  Crimea,  planted  the  seeds  of  disease,  which 
terminated  in  death  from  cancer  of  the  liver  on  the  27th  of 
January,  1858.  He  was  the  author  of  more  than  twenty 
works,  chiefly  upon  military  and  hospital  surgery. 


AUTHOR'S     PREFACE. 


WHILE  on  my  mission  in  the  Army  of  the  East, 
Marshal  Vaillant,  Minister  of  War,  did  me  the  honor 
to  write : — 

"We  wish  you  to  turn  to  account  the  important 
mission  with  which  you  have  been  intrusted  in  the 
East,  and  desire  you  to  report  what  you  have  seen  of 
the  state  of  our  military  and  field  hospitals,  and  how 
our  establishments  for  restoring  health  in  the  army  of 
the  East  compare  with  those  of  previous  wars,  the 
efforts  of  the  hospital  service,  and  everything  upon 
which  our  physicians  have  bestowed  so  much  zealous 
devotion,  intelligence,  and  heart.  You  will  be  expected 
to  describe  the  diseases  that  prevail,  and  those  that  we 
should  apprehend ;  the  means  employed  to  prevent  or 
remove  them,  and  the  operations  of  surgery,  with  their 
successful  or  fatal  issue. 

"  You  will  report  your  views  concerning  the  present 
organization  of  the  health  service,  and  its  operation  in 
our  hospitals,  the  army,  and  the  interior,  and  upon  the 
improvements  that  should  be  made  in  it.  I  shall  attach 
great  importance  to  your  views  upon  these  subjects. 
The  English  and  Sardinian  armies  may  fwnish  facts  for 
comparison,  if  not  for  instruction,  and  upon  this  subject 
we  should  take  large  and  liberal  views.  I  will  not  pre- 
sume to  lay  down  a  plan,  but,  my  dear  doctor,  you  see 
what  I  desire,  and  no  Medical  Inspector  has  for  a  long 
time  been  placed  in  so  fine  a  position  for  rendering  sub- 
stantial services  to  Science." 

On  the  same  day  I  received  from  Baron  Charles 
Dupin,  Senator,  and  Member  of  the  Institute,  another 
letter,  of  which  the  following  are  extracts  : — 


xii  AUTHOR'S  PREFACE. 

"  The  Medical  Service  of  our  armies  was  never  better 
organized,  its  agents  better  instructed  or  more  zealous, 
and  its  materiel  more  complete,  or  in  better  state  for 
use.  A  report  from  you,  as  Inspector  General,  upon 
the  condition  of  the  Medical  Service  in  the  Crimea  and 
at  Constantinople,  its  extraordinary  services  under  fire, 
in  three  battles,  and  in  a  memorable  siege,  the  assistance 
prepared  at  the  theatre  of  combat,  and  in  places  where 
inventive  genius  and  a  love  of  humanity  must  supply 
all  our  wants,  so  far  away  from  France,  and  in  a  rude 
season  of  the  year.  In  addition  to  these,  the  develop- 
ment of  epidemics, — the  cholera  and  typhus,  may  double 
the  ravages  of  war  ;  and  there  will  be  afforded  you  an 
opportunity  for  rendering  sublimer  services  than  ever 
fell  to  the  lot  of  Larrey,  your  predecessor,  in  the  history 
of  our  armies. 

"I  have  given  you,  sir,  a  brief  and  imperfect  pro- 
gramme, drawn  at  too  great  a  distance,  and  with  a 
hand  little  competent,  but  with  an  earnest  and  vivid 
regard  for  the  honor  of  France,  and  the  glorious  titles 
earned  by  the  armies  which  you  have  the  honor  to 
represent.  I  doubt  not  but  that  in  our  army  of  the 
East,  Science  will  attain  new  facts  in  the  art  of  healing. 
You  will  assuredly  collect  and  weave  them  into  a  pic- 
ture, in  which  Art  shall  recognise  the  master's  hand." 

These  noble  suggestions  pointed  out  to  me  an  end  so 
elevated  that  I  dare  not  hope  to  attain  it,  but  they 
decided  me  in  undertaking  this  labor,  which  the  Revue 
des  Deux  Mondes  first  published,*  and  which  I  here 
collect  in  a  volume. 

The  grand  memories  of  the  Crimean  war  belong 
chiefly  to  history  ;  and  now  wise  and  useful  measures, 
as  well  as  errors  and  faults,  may  be  discussed  with 
equal  loyalty  and  double  profit,  to  the  end  that  hence- 
forth, instructed  by  experience,  we  may  be  able  with 
certainty  to  adopt  the  one,  and  carefully  avoid  the 
other, 

*  The  numbers  for  February  15th,  April  1st,  and  June  1st,  1857. 


THE    CRT MEAN    WAR. 


PART    I. 

THE  CAMPS, 

THE  war  of  the  East,  so  full  of  instruction  in  military 
science,  was  not  barren  of  medical  teachings.  Its  field 
of  observation,  vast  indeed,  and  often  melancholy,  fur- 
nished opportunities  for  submitting  to  decisive  proof, 
and  sometimes  even  for  settling,  grave  problems  of 
hygiene,  medicine,  and  surgery,  which  had  until  then 
remained  in  doubt.  The  army  profited  by  these  new 
discoveries,  which  lightened  the  pains  of  the  sick  and 
wounded,  and  its  ills  were  relieved  or  altogether  re- 
moved by  its  surgeons,  whose  ceaseless  devotion,  and 
unwearied  zeal,  have  many  times  deserved  the  warm 
encomiums  bestowed  by  the  Commander  in  Chief,  and 
the  Minister  of  War.  Their  labors  resolved  themselves 
into  three  classes,  viz,  prophylactic  measures,  or  those 
employed  to  prevent  diseases  ;  the  care  of  those  wounded 
in  war ;  and  the  treatment  of  diseases,  which,  as  we 
know,  made  terrible  ravages.  This  threefold  duty 
points  out  three  great  centres  of  experience — the  camps, 
the  field  hospitals,  and  the  regular  hospitals  of  the  army. 
On  the  25th  of  July,  1855, 1  was  appointed  Inspector 
of  the  Health  Service  of  Corsica,  Italy,  and  the  Army 
of  the  East.  Having  inspected  Italy  and  Corsica,  I 
departed  for  the  Crimea  towards  the  end  of  September, 
and  thus  found  myself,  after  the  taking  of  Sebastopol, 
upon  the  theatre  of  wTar.  This  war  presents  to  the 
mind  two  impressions :  the  one  glorious  in  brilliant  feats 

2 


10  THE   CRIMEAN   WAR. 

of  arms,  the  other  mournful  from  passive  sufferings. 
Of  the  one,  the  world  knows  the  fullest  details ;  while  of 
the  other,  it  has  but  vague  ideas.  Let  us  enlighten  this 
subject,  and  we  shall  learn,  that  it  is  not  alone  in  the 
assaults  of  battle,  that  our  soldiers  always  display  the 
greatest  courage. 


i  CHAPTER    I. 

MEDICAL   TOPOGRAPHY    OF   THE   CRIMEA. 

THE  steamer  upon  which  I  embarked,  had  on  board  a 
battalion  of  the  llth  legion,  and  when  we  reached  Malta, 
thirty  men  had  already  been  attacked  by  cholera.  They 
were  placed  in  charge  of  the  Sister^  of  Charity,  and 
sent  to  the  Lazaretto,  where  a  small  hospital  had  been 
arranged  for  soldiers  taken  severely  ill  on  the  passage, 
and  unable  to  continue  their  voyage,  without  endanger- 
ing themselves  or  their  comrades.  It  would  have  been 
desirable  to  form  a  great  hospital  establishment  at  Malta, 
for  the  army  of  the  East,  but  the  resources  were  wanting, 
even  to  the  English.  Still,  the  few  beds  which  the 
Lazaretto  contained,  were,  as  a  sanitary  measure,  of  great 
value ;  and  at  the  end  of  the  war,  when  typhus,  imported 
from  the  Crimea,  threatened  to  spread  in  the  south  of 
France,  and  through  the  fleets,  we  were  able  to  escape 
the  dangers  of  infection,  by  leaving  at  Malta  a  certain 
number  of  typhic  patients.  The  governor  of  the  island, 
as  well  as  the  consul  of  France,  Mr.  Henry  Fourcade, 
left  nothing  undone.  The  governor  not  only  received 
foreign  soldiers  upon  the  island,  contrary  to  traditional 
usages  and  positive  instruction,  but  even  raised  the 
quarantine  for  our  benefit ;  nor  did  they  have  cause  to 
repent  of  this,  for  neither  cholera  nor  typhus  gained  a 
hold  in  Malta,  although  its  hospital  received  many 
times,  both  choleric  and  typhic  patients. 

Malta  is  two  days'  sail  from  Smyrna,  and  the  cholera 
continuing,  four  dead  bodies  were  thrown  into  the  sea. 


THE   CRIMEAN   WAK.  11 

Uneasiness  and  alarm  began  to  prevail.  The  young 
soldiers  who  encumbered  the  decks,  had  no  other  cover- 
ing but  the  sky,  and  their  clothing  was  saturated  with 
the  dews  of  the  chilly  nights,  succeeding  the  tropical 
heat  of  the  days.  I  caused  to  be  distributed  warm  wine 
at  nine  o'clock  in  the  evening,  and  an  infusion  of  tea  at 
four  in  the  morning.  A  salutary  reaction  checked  the 
progress  of  the  malady,  and  restored  gaiety  and  songs. 
Some  cholera  patients,  already  cold  and  purple,  were 
recalled  to  life  by  these  stimulants,  and  twelve  who 
remained,  were  placed  in  the  small  French  Naval  Hos- 
pital at  Smyrna. 

We  found  at  Smyrna  a  magnificent  barrack,  sufficient 
to  accommodate  six  thousand  men,  which  the  Marshal 
St.  Arnaud  had  thought  of  changing  into  a  hospital  for 
our  troops.  A  noted  locality  of  thermal  waters,  called 
the  Baths  of  Agamemnon,  occurs  a  few  miles  from 
Smyrna,  and  the  road  thither  .leads  past  the  site  of  an 
ancient  temple  of  Esculapius,  whose  vast  ruins  indicate 
a  gigantic  edifice,  now  replaced  by  a  Jews'  cemetery, 
destitute  of  shade  or  monuments.  The  road  is  excellent, 
and  affords  easy  communication  between  the  city  and 
the  baths.  The  marshal's  project  would  therefore  have 
been  excellent,  had  it  been  at  once  adopted ;  but  he  was 
delayed  by  groundless  apprehensions  of  the  salubrity  of 
the  country,  and  the  English  meanwhile,  more  resolute, 
established  a  very  large  hospital  at  Smyrna.*  In  the 

*  The  English  Civil  Hospital  at  Smyrna,  consisted  of  a  large  Turkish 
barrack,  situated  close  to  the  sea,  and  almost  on  a  level  with  it,  at 
the  south-west  angle  of  the  city.  The  building  formed  three  sides  of 
a  square,  open  to  the  bay,  so  as  to  be  freely  exposed  to  the  sea  breeze 
and  the  summer  wind,  the  "Imbat,"  which  blew  directly  from  the  sea 
to  the  hospital  from  9  A.M.  to  6  P.M.  The  general  sanitary  condition 
of  the  locality  was  decidedly  bad,  and  the  wonder  was  that  pesti- 
lence, in  some  form,  was  ever  absent  from  the  coast.  By  careful 
cleanliness,  the  hospital  was  kept  measurably  free  from  malarious 
influences.  Sanitary  regulations  were  ordered  by  Dr.  Sutherland, 
March  28,  1855,  requiring  the  streets  adjacent  to  be  cleansed  daily, 
and  nuisances  to  be  abated;  the  street  drains  to  be  cleansed  and 
covered;  the  drains  close  to  the  hospital  to  be  cleaned  by  flushing, 
and,  if  necessary,  to  be  relaid;  the  privies  to  be  disinfected,  and 
water-closets  substituted ;  ventilation  to  be  thoroughly  extended,  and 
all  excreta  to  be  thoroughly  removed. — TB. 


12  THE   CRIMEAN   WAR. 

winter  of  1856,  having  no  more  sick  at  that  place,  they 
stationed  there  a  brigade  of  infantry. 

In  leaving  Smyrna,  we  passed  near  Tenedos,  not  far 
from  the  tombs  of  Ajax,  Hector,  and  Achilles,  and 
within  sight  of  Mount  Ida,  and  the  plain  where  Troy 
was.  The  name  of  every  village  and  locality  recalled  a 
classic  memory.  We  entered  the  Dardanelles,  passed 
Abydos,  on  the  Asiatic  side,  and  four  miles  further  the 
quiet  of  this  region  was  replaced  by  great  activity,  the 
English  being  there  constructing  a  hospital  for  three 
thousand  sick.  The  site  was  well  chosen  to  meet,  at 
the  same  time,  the  demands  of  health,  and  capacity  for 
defence.  Further  on  we  found  two  hospitals,  one 
belonging  to  the  English,  intended  for  three  hundred 
sick,  and  the  other  French,  with  four  hundred  and 
twenty  beds.  The  latter  had  been  established  in  a 
Turkish  Lazaretto,  and  they  had  unfortunately  built  four 
large  rooms  in  the  middle  of  the  central  court,  instead 
of  placing  them  without,  upon  a  little  hill,  which  sloped 
gently  towards  the  place.  This  error  prevented  the  cir- 
culation of  air,  and  was  the  more  to  be  lamented  when 
they  were  afterwards  required  to  receive  patients 
infected  with  Hospital  Gangrene. 

Upon  landing  at  Gallipolis,  I  visited  the  French  Hos- 
pital, and  found  another  fault  in  the  arrangement.  To 
turn  to  use  a  considerable  stretch  of  wall,  they  had 
begun  by  building  sheds  against  it,  at  the  foot  of  a  hill, 
without  noticing  the  drainage  of  the  soil;  but  were 
shown  their  error,  when  cholera  appeared  on  the  pre- 
mises. These  blunders,  unfortunately  not  rare,  might 
have  been  avoided  by  consulting  physicians, -who,  know- 
ing the  efficacy  of  air  constantly  renewed,  especially  in 
warm  climates,  where  the  rigors  of  winter  are  not  felt, 
select  elevated  and  not  sheltered  sites  ;  but  the  quarter- 
masters for  barracks  were  not  always  occupied  with 
these  views,  and,  as  in  France,  might  be  said  to  under- 
stand everything  but  hygiene.  If  the  pupils  of  Saint  Cyr* 
were  to  devote  only  a  dozen  hours  to  hearing  a  dozen 

*  Saint  Cyr  is  the  great  military  school  specially  devoted  to  the 
French  cavalry  service. — TR. 


THE   CRIMEAN  WAR.  13 

lectures  upon  health,  they  would  carry  into  the  army 
certain  principles  of  science,  from  which  the  soldiers 
would  derive  substantial  benefits ;  the  advice  of  physi- 
cians would  be  oftener  heard  ;  and  the  perils  of  epidemic 
diseases,  to  which  our  armies  are  constantly  liable, 
would  often  be  avoided.  The  organization  of  these  hos- 
pitals was  at  least  blameless ;  the  furniture,  beds,  food, 
and  fixtures  left  nothing  to  be  desired  ;  and  the  medical 
service  was  perfectly  well  directed.  Everything  bore  evi- 
dence of  an  active  zeal  and  an  enlightened  solicitude. 

We  crossed  the  Sea  of  Marmora  during  the  night,  and 
at  the  dawn  of  day,  the  splendid  panorama  of  Constanti- 
nople, and  of  Seraglio  Point,  opened  to  our  view.  The 
slender  shafts  of  the  minarets,  piercing  the  azure  sky, 
were  ranged  like  a  guard  of  honor  around  the  grand 
mosques  which  commanded  St.  Sophia;  the  air  was 
filled  with  a  thin  vapor,  and  the  landscape,  dotted  with 
pavilions  and  crowned  with  a  cypress  grove,  seemed 
like  a  realization  of  the  reveries  of  the  Thousand  and 
One  Nights.  It  is  a  pity  that  the  charm  should  vanish 
as  soon  as  one  steps  into  the  labyrinth  of  its  narrow 
muddy  streets,  full  of  quagmires,  and  overrun  with  street 
porters  of  Herculean  strength  (a  race  of  biped  camels 
that  they  call  hamals),  with  dogs,  and  with  asses- laden 
with  boards.  The  houses  are  of  wood,  of  miserable 
aspect,  and  without  architectural  style  or  character. 

I  at  once  visited  the  hospitals,  where  the  sick,  who 
had  come  from  the  Crimea,  were  chiefly  tainted  with 
intestinal  diseases,  intermittent  and  remittent  fevers, 
and  especially  with  scurvy.  In  the  wounded,  the  taint 
of  scurvy  impoverished  the  blood,  which  became  more 
fluid,  and  oozed  from  the  wounds  in  abundance,  so  that 
the  most  energetic  appliances  of  science  could  not  con- 
trol these  haemorrhages,  and  they  very  often  proved 
fatal.  A  still  more  terrible  disease,  the  Hospital  Gan- 
grene, made  fearful  havoc.  Many  of  the  wounded  from 
the  Crimea,  and  those  who  had  until  now  escaped,  were 
tainted  after  a  brief  residence  in  the  hospitals,  and 
wounds  almost  closed,  and  considered  as  healed,  were' 
invaded  by  the  gangrene.  This  scourge,  which  had  but 
rarely  been  seen  in  Algeria,  had,  before  I  left  for  the 


14  THE   CRIMEAN   WAR. 

east,  already  appeared  in  our  hospitals  at  Marseilles 
and  in  the  south,  which  received  the  wounded  from  the 
Crimea.  It  is  contagious,  and  is  transmitted  by  the  air 
from  one  wounded  person  to  another,  so  that  in  a  ward 
impregnated  with  its  miasm,  it  is  very  difficult  to 
exterminate  it. 

On  the  5th  of  October,  1855,  I  left  Constantinople 
for  the  Crimea,  on  board  the  steam  frigate  Descartes, 
Captain  Darricau,  and  left  it  with  regret  at  Kamiesch. 
Reporting  myself  at  the  General's  quarters  and  to  Mar- 
shal Pelissier,  I  at  once  set  to  work,  in  studying  the 
great  questions  of  hygiene,  necessary  to  be  settled  upon 
the  approach  of  winter.  I  visited,  upon  horseback,  the 
various  positions  occupied  by  our  army,  the  camps,  and 
the  field  hospitals,  at  the  same  time  taking  note  of  the 
medical  topography  of  the  country. 

The  part  occupied  by  the  Russians  was  almost  entirely 
uncultivated,  covered  by  immense  plains,  and  without 
water ;  while  that  on  which  the  Allies  had  encamped  at 
the  time  of  our  arrival,  was  dotted  with  cultivated  spots, 
and  vineyards  of  considerable  note.  The  soil  was  a 
dark  vegetable  mould,  easily  washed  by  the  rains,  and 
the  mud  of  the  Crimea  defies  all  description.  This 
layer  of  mould  varies  from  one  to  several  yards  in  thick- 
ness, and  the  subsoil  is  a  porous  limestone,  easily  torn 
up  by  the  pick.*  The  regiments  that  were  encamped 
in  places  where  this  subsoil  appeared,  dug  circular  pits 
about  four  or  five  feet  deep,  to  place  their  tents,  thus 


*  The  geological  features  of  the  Crimea  are  concisely  as  follows : — 
The  western  portion,  extending  as  far  east  as  a  meridian  passing 
through  the  head  of  SebasLopol  harbor,  consists  of  the  Upper  Ter- 
tiary or  Steppe  limestone,  so  often  mentioned  in  this  volume,  and  of 
a  light  porous  structure.  Along  the  shore,  from  Sebastopol  to  the 
western  third  of  the  southern  coast,  is  a  belt  of  volcanic  sand  and 
ashes ;  and  from  the  monastery  of  San  Georgeo  westward,  is  a  belt  of 
erupted  volcanic  rocks,  forming  vast  picturesque  masses  along  the 
coast.  The  British  and  Sardinian  camps,  and  the  forests  of  Bai'dar, 
were  underlaid  by  Jurassic  limestone ;  the  borders  of  the  Tchernaia, 
from  the  Russian  camps  on  the  north,  to  the  French  camps  and  battle- 
fields of  Balaclava  on  the  south,  by  chalk  and  green  sand  formations. 
A  tract  along  the  southern  border  from  Col,  eastward,  is  underlaid 
by  schist  and  conglomerate. — Tn. 


THE   CRIMEAN   WAR.  15 

avoiding  the  cold,  and  especially  the  winds,  which  are 
continual,  and  sometimes  terrible,  in  the  Crimea. 

On  the  14th  of  November,  1854,  the  winds  unloosed, 
and,  attended  with  torrents  of  rain,  threatened  the 
allied  armies  with  a  great  disaster.  The  tents,  sheds, 
and  shelters  for  provisions  were  overturned  and  swept 
level,  in  the  camps,  while  the  ships  at  anchor  were 
beaten  and  shattered,  and  the  Henri  IV.  and  Pluton 
of  our  imperial  marine,  sustained  irreparable  damages 
in  the  Bay  of  Eupatoria.  At  Kamiesch  and  at  Bala- 
clava, the  transports  suffered  great  injury;  and  at  the 
entrance  of  the  latter  port,  eight  large  vessels,  laden 
with  munitions,  provisions,  and  clothing  for  the  English, 
were  sunk,  with  part  of  their  crews. 

We  ought  not,  however,  to  complain  of  the  violence 
of  the  winds  in  the  Crimea,  for  without  them  the  soil 
would  be  constantly  muddy,  notwithstanding  its  surface 
drainage.  The  wind  renewed  the  air  of  our  camps, 
and  swept  off  the  mephitic  gases  with  which  the  cloth- 
ing was  filled  ;  it  bore  off  the  miasms  of  dead  men  and 
animals,  buried  by  thousands,  but  which,  although 
buried,  could  not  decay  harmlessly;  and  if  the  wind 
did  not  keep  us  from  the  typhus,  it  at  least  lessened 
its  effect;  and  perhaps  to  it,  we  may  have  owed  our 
exemption  from  the  plague. 

The  district  occupied  by  the  Allies,  measured  five 
miles  in  breadth,  by  about  fifteen  in  length.  It  was  the 
'  ancient  Tauric  Chersonesus,  of  which  Herodotus  and 
Strabo  have  left  descriptions,  and  like  the  Troad,  it 
called  up  the  memories  of  heroic  ages.  It  was  hither 
that  Diana  transported  Iphigenia,  snatched  from  the 
sacrificial  fire,  and  here  she  made  her  a  priestess ;  upon 
this  inhospitable  shore  the  tempests  threw  Orestes  and 
Pylades,  and  where  Iphigenia  failed  to  sacrifice  her 
brother.  Henceforth  other  recollections  will  efface 
these  ancient  traditions,  and  the  names  of  our  victories 
will  eclipse  those  of  Orestes  and  his  sister. 

The  roadstead  of  Sebastopol  is  striking  from  its  extent, 
and  its  majestic  appearance.  It  was,  so  to  speak,  staked 
out  by  the  masts  of  sunken  vessels,  which  reared  their 
points  as  if  to  mark  the  place  of  a  great  ruin.  Upon 


16  THE  CRIMEAN  WAR. 

entering  the  roadstead,  we  meet  the  little  Bay  of  Care- 
nage,  from  the  head  of  which  the  Russian  vessels,  during 
the  siege,  threw  volleys  of  iron  shot ;  and  two  and  a  half 
miles  beyond,  is  the  mouth  of  the  Tchernaia,  which 
flows  among  the  reeds  through  a  marshy  country,  and 
whose  waters  are  in  part  diverted  to  feed  the  docks  of 
Sebastopol.  The  fine  road  to  Sympheropol,  crossing 
the  Tchernai'a  upon  a  wooden  bridge,  winds  up  the 
hills,  behind  which  was  encamped  the  army  of  Gene- 
ral Bosquet.  It  passes  the  spot  where  the  English  were 
encamped,  when  the  Russians  attacked  them,  and  the 
battle  of  Inkermann  was  fought,  November  5,  1854. 

Prince  Menchikof,  whose  army,  elated  by  the  pre- 
sence of  the  grand-dukes  Michael  and  Nicholas,  had  re- 
ceived large  reinforcements,  attacked  the  allied  troops 
at  three  points  simultaneously.  While  General  Liprandi 
made  a  vigorous  attack  on  Balaclava,  the  corps  of 
General  Dannenberg  sought  to  gain  the  heights  of 
Inkermann,  taking  in  the  rear  the  besieging  army, 
which  was  being  attacked  from  the  other  side  by  the 
battalions  of  General  Timofeif  that  issued  from  Sebas- 
topol, hoping  thus  to  cut  off*  our  communications  with 
Balaclava  and  Kamiesch. 

We  know  of  the  heroic  defence  made  by  the  English, 
as  they  were  attacked  about  daybreak,  in  their  camps, 
without  any  works  of  consequence  to  protect  them. 
These  valiant  troops,  commanded  by  the  Duke  of  Cam- 
bridge, fought  with  valor  the  compact  masses  pressed  * 
against  them.  The  corps  of  General  Bosquet  coming 
up  in  haste,  turned  the  Russian  columns  by  bayonet 
charges,  while  General  De  Lourmel  vigorously  repulsed 
the  Russians  under  the  walls  of  the  city,  and  met  a 
glorious  death.  General  Canrobert,  who  planned  by 
wise  arrangements  all  the  movements,  was  wounded 
in  the  elbow,  but  fortunately  not  dangerously.  Our 
ambulances  collected  about  500  of  the  enemy's  wounded, 
and  it  is  estimated  that  6,000  dead  bodies  of  the 
Russians  were  left  upon  the  battle-field.  The  English 
lost  three  generals,  a  hundred  officers,  and  a  multitude 
of  soldiers ;  and  our  loss,  though  much  less,  included 
about  500  wounded.  After  this  great  battle,  we  out  up 


THE   CRIMEAN   WAR.  17 

the  road,  here  and  there,  with  enormous  trenches,  to 
render  another  surprise  more  difficult.  On  their  part, 
the  Russians  destroyed  the  bridge,  to  cover  their  retreat. 
At  the  foot  of  the  mountain,  from  the  top  of  which 
the  Russian  battalions  were  thrust  by  our  soldiers, 
was  a  true  ossuary,  the  bodies  having  been  devoured  by 
vultures,  leaving  the  skeletons  only  of  the  men  to  await 
burial.  These  skeletons  had  belonged  to  men  whose 
stature  was  not  great,  but  whose  frames  were  remarka- 
bly firm ;  and  the  femur  or  tibia  of  a  Russian,  very 
easily  distinguished  him  from  a  Frenchman  or  an  Eng- 
lishman. 

The  valley  of  the  Tchernaia  ascends  towards  the  east, 
to  the  forest  of  Baidar,  with  an  average  breadth  of 
about  four  hundred  and  fifty  yards.  Its  air  is  sickly, 
and  it  was  impossible  to  improve  it  in  the  whole  course 
of  the  war.* 

From  the  tops  of  the  hills  which  bordered  the  valley, 
the  hostile  camps  were  in  view  of  each  other,  and  after 
the  taking  of  Sebastopol,  some  of  the  soldiers  of  the 
advanced  posts  established  communications  with  one 
another,  by  means  of  white  handkerchiefs  fixed  to  the 

*  The  valley  of  the  Tchernaia  is  thus  described  by  Dr.  Sutherland, 
in  the  Report  of  the  Sanitary  Commission  dispatched  by  the  British 
Government  to  the  seat  of  war  in  the  East. 

"  To  the  north  of  tke  ridge,  forming  the  northern  margin  of  the 
basin  [of  Balaclava],  lies  the  valley  of  Tchernaia.  From  the  crest  of 
the  ridge  the  ground  falls  gradually  to  the  foot  of  a  chain  of  hills 
called  'Fedoukine  Heights,'  which  rise  rapidly  to  an  elevation  of 
500  feet  above  the  sea  level.  From  their  summits  there  is  a  rapid 
descent  to  the  level  of  the  Tchernaia.  The  valley  through  which  the 
river  flows  is  broad  and  tolerably  flat.  The  bottom  is  chiefly  of  marl 
mixed  with  pebbles  and  chalky  debris,  and  the  bed  of  the  river,  which 
is  only  a  few  yards  wide,  and  is  scooped  out  of  the  debris  to  a  depth  of 
four  to  six  feet.  Most  of  the  ground  is  perfectly  firm  in  ordinary 
states  of  the  weather,  but  as  the.  river  approaches  the  head  of  Sebas- 
topol harbor,  the  ground  becomes  a  marsh.  .  *  *  *  The  greatest 
breath  of  the  valley,  measured  from  its  southern  boundary  ridge  to 
the  foot  of  Mackenzie's  Heights,  is  about  six  miles,  and  the  length  of 
the  wider  part  below  Tchorgoun  is  about  five  and  a  quarter  miles  to 
Inkermann  Castle,  where  the  precipices  of  the  plateau  approach 
those  of  Inkermann,  and  between  them  lies  the  marsh  at  the  mouth 
of  the  river.  The  whole  of  the  valley  is  covered  with  grass  and 
flowers,  and  there  are  no  trees  except  in  the  marsh." — TR. 

2* 


18  THE   CRIMEAN   WAE. 

points  of  their  bayonets.  To  these  visits  succeeded 
exchanges,  the  Russians  having  brandy,  and  the  French 
bread  and  tobacco  ;  they  became  very  fraternal,  and  this 
kind  of  amicable  warfare  extended  so  far,  that  General 
Camou,  of  the  2d  Corps,  found  it  necessary  to  cool  off 
the  heat  of  these  eifusions  by  punishments. 

On  entering  the  valley,  we  noticed  on  the  left,  the 
Mackenzie's  Heights,  veritable  walls,  straight  and  inac- 
cessible, with  a  central  depression,  as  if  to  invite  assault, 
but  protected  in  the  rear  by  three  stages  of  command- 
ing banks.*  The  Russians  had  thickly  planted  these 
escarpments  with  cannon,  and  from  thence  thundered 
the  batteries  named  by  our  soldiers  Btiboguet  and 
G-ringalet,  which,  after  the  battle  of  Traktir,  made  such 
sad  havoc  by  firing  upon  our  physicians  and  their  ser- 
vants, while  busy  in  dressing  and  attending  the  wounded 
Russians.  A  similar  occurrence  happened  after  the 
battle  of  Inkermann,  but  the  Russian  government 
hastened  to  disapprove  of  these  barbarous  acts,  and 
General  Liiders  did  much  to  atone  for  them,  in  his  cor- 
respondence with  Generals  Canrobert  and  Pelissier. 
These  mistakes  would  be  rendered  impossible,  if,  by  the 
common  consent  of  nations,  physicians  and  their  hospital 
attendants  were  to  bear  a  distinctive  badge,  alike  in  the 
armies  of  all  countries,  and  such  as  would  be  easily 
recognised  by  both  parties. 

Further  on  we  find  the  bridge  of  Traktir,  by  which 
the  Russian  columns  sallied  out  the  16th  of  August,  1855. 
It  is  commanded  by  the  Fedoukine  Heights,f  held  by 
General  MacMahon's  corps.  The  valley  is  at  this 
place  some  two  or  three  hundred  yards  wide,  and  is 
traversed  by  two  streams,  the  Tchernai'a,  and  a  canal  of 
supply,  separated  by  a  space  of  about  a  hundred  yards. 
Its  banks  on  either  side  were  high,  steep,  and  furrowed 
by  ravines.  In  these  positions,  rendered  still  more 

*  These  Heights  form  a  long  almost  horizontal  ridge  of  precipices 
of  chalk,  rising  to  the  height  of  about  1000  feet  above  the  level  of  the 
sea,  and  resting-  on  a  steep  talus,  extending  from  one  end  of  the  ridge 
to  the  other. — TR. 

\  These  hills  rise  rapidly  to  an  elevation  of  five  hundred  feet  above  - 
the  sea.     They  consist  of  loose  chalk  with  layers  of  Hint. — TR. 


THE   CRIMEAN   WAR.  19 

formidable  by  entrenchments  covered  with  cannon,  the 
French  and  Russian  armies  lay  encamped  face  to  face, 
and  the  disadvantages  that  would  attend  either  of  the 
two  armies  that  should  go  to  attack  the  other,  were  so 
great,  that  it  would  not  be  difficult  to  foresee  the  result 
of  the  combat  of  August  16th,  while,  moreover,  the 
precautions  taken  by  General  Pelissier  placed  us  beyond 
peril  from  surprise.  At  four  o'clock  in  the  morning,  six 
divisions  of  Russian  infantry,  supported  by  160  cannon, 
and  three  divisions  of  cavalry,  under  the  command  of 
Prince  Gortschakof,  passed  the  streams,  upon  several 
bridges,  screened  by  fog,  and  attacked  with  fury  our 
lines  and  advanced  posts  of  Piedmontese.  The  conflict 
became  general ;  the  Russian  columns,  when  turned 
back,  were  quickly  rallied,  and  advanced  repeatedly  to 
the  charge,  but  were  again  hurled  back  by  the  French 
bayonets,  and  crowded  upon  the  bridges,  across  which 
they  were  beaten  and  driven  by  nine  o'clock  in  the 
morning.  General  Pelissier  reported  3,329  Russians 
killed,  of  whom  2,129  were  buried  by  us,  and  there 
remained  upon  the  field  1,669  wounded  Russians,  38  ot 
whom  were  officers,  which  were  collected  by  our  ambu- 
lances. Our  loss  was  as  follows: — 19  officers  killed, 
and  61  wounded;  172  non-commissioned  officers  and 
privates  killed,  146  missing,  and  1,163  wounded. 

The  whole  of  the  left  side  of  the  valley  was  guarded 
by  the  French  army,  and  even  after  the  taking  01 
Sebastopol,  the  divisions  of  the  first  corps,  under  Gene- 
ral Salles,  extended  as  far  up  as  into  the  forest  of  Bai'dar. 
A  change  of  bivouac,  and  location  in  the  woods,  proved 
favorable  to  the  health  of  the  soldiers.  The  forest  has 
a  rich  vegetation  and  frowning  aspect — it  has  for  its 
outline  majestic  mountains,,  furrowed  by  valleys,  and 
picturesque  hamlets  dot  the  slopes.  Here  and  there 
we  notice  elegant  hunting  lodges,  such  as  the  Chateau 
of  Perouski  ;  and  the  springs  of  fresh  and  clear  water 
in  this  region  form  the  sources  of  the  Tchernai'a.  No 
better  bivouac  could  be  found  than  in  this  forest,  where 
the  division  of  Autemarre  remained  in  the  best  condition 
throughout  the  severe  winter  of  1856,  although  one 
night  in  three  was  passed  on  guard. 


20  THE   CRIMEAN   WAE. 

If  from  the  forest  of  Baidar  we  turn  our  steps  to  the 
east  and  south,  we  come  by  a  series  of  mountains,  where 
the  Sardinian  army  was  encamped  with  its  field  hospitals, 
to  the  little  port  of  Balaclava,  hidden  in  a  sinuous  open- 
ing between  immense  rocks.*  It  was  formerly  a  secure 
retreat  for  pirates,  and  we  may  still  trace  the  ruins  of  a 
fort  built  in  the  thirteenth  century  by  the  Genoese. 
This  place  contained  only  a  few  families  of  fishermen 
when  the  English  arrived,  bringing  with  them  their 
industry.  They  built  a  railroad,  and  a  hundred  ships 
discharged  continually  the  products  of  civilization. 
The  camps  of  our  allies  were  largely  supplied  with 
every  article  of  need,  by  which  they  escaped  the  scurvy 
and  typhus  in  1856.  When  we  compare  the  destitute 
condition  of  the  English  army  at  the  opening  -of  the 
war,  with  its  state  in  1856,  we  cannot  but  admit  the 
vigor  of  the  British  government. 

The  general's  quarters  in  the  Sardinian  army  were 
fixed  at  the  Greek  village  of  Kadikeui,  which  was 
invaded  for  the  time  being  by  a  population  of  cosmo- 
polite merchants  ;  and  General  Marmora  invited  me  to 
visit  the  field  hospitals  of  the  Piedniontese  army,  whose 
management  and  attendance  deserved  nothing  but 
praise. 

Between  Kadikeui  and  the  valley  of  the  Tchernai'a, 
extends  an  undulating  field,  where,  on  the  25th  of  Octo- 
ber, 1854,  was  fought  the  battle  of  Balaclava.  In  the 
morning,  the  troops  under  General  Liprandi,  sustained 
by  powerful  artillery,  and  numerous  squadrons,  took 
four  unfinished  redoubts,  which  the  Turks  had  aban- 

*  Dr.  Sutherland  thus  describes  the  topography  and  geology  of  the 
port  of  Balaklava : — 

"  The  coast  line  of  mountain-ridge,  is  at  this  point  broken  across  by 
a  deep  sigmoid  fissure,  forming  the  entrance  of  the  harbor  of  Bala- 
clava. On  the  west  side  of  the  entrance,  the  rock  sinks  almost  per- 
pendicularly into  the  water,  and  on  the  east  side  the  entrance  is 
bounded  by  a  singular  conical  hill  469  feet  high,  on  the  summit  and 
side  of  which,  are  the  ruins  of  the  old  Genoese  castle  of  Balaklava. 
The  western  slope  of  this  hill  consists  of  masses  of  the  same  compact 
reddish  limestone,  arid  the  bulk  of  the  hill  itself  is  formed  of  detached 
fragments  of  the  same  rock,  or  rather  of  a  brecciated  form  of  it,  resting 
on  highly  inclined  beds  of  conglomerate." — Report  of  Special  Sanitary 
Commission,  p.  220. — TR. 


THE   CRIMEAN   WAK.  21 

doned  after  a  vigorous  defence,  and  began  a  series  of 
cavalry  combats,  in  which  the  advantage  remained  with 
the  English,  when  an  ill-timed  or  badly-interpreted  order 
saddened  the  events  of  the  day.  The  Russians  having 
taken  some  cannon  near  the  redoubts,  the  light  horse 
under  General  Cardigan  received  orders  to  re-capture 
them,  a  thing  next  to  impossible.  These  splendid 
squadrons  rushed  forward,  sabred  the  cannoniers  of  the 
Russians  at  their  pieces,  and  swept  through  compact 
columns,  but  assailed  on  every  side  by  overpowering 
numbers  and  a  storm  of  shot,  they  turned  upon  their 
course,  and  opened  again  a  passage  through  the  ranks 
of  the  enemy,  until,  with  the  aid'of  the  African  Chas- 
seurs of  General  Morris,  they  regained  our  lines  with 
only  half  their  numbers,  the  rest  being  left  upon  the 
battle-field.  It  is  known,  that  the  order  to  charge, 
emanating  from  Lord  Raglan,  was  taken  to  General 
Lucan  by  Captain  Nolan,  who  was  killed  in  the  charge, 
and  it  is  altogether  probable  that  it  was  not  imperative. 
In  passing  south,  over  the  high  plateaux  which  extend 
along  the  sea  near  Balaclava,  we  come  to  the  Cape  Fior- 
ente  of  the  Genoese,  the  ancient  Cape  Parthenion,  where 
are  found  some  traces  of  the  temple  of  the  Tauripolitan 
Diana,  in  which  king  Thoas  sacrificed  strangers.  Near 
these  ruins,  in  a  recess  among  the  rocks,  and  sheltered 
from  the  north  wind,  is  the  beautiful  monastery  of  Saint 
George,  the  asylum  of  pensioners  retired  from  the 
Russian  fleet.  Although  a  fine  hospital  might  have 
been  established  here,  the  allied  armies  respected  with 
care  this  monastery  ;  its  religious  ceremonies  were  never 
molested,  but  were  performed  daily  in  the  presence  of  a 
heterodox  crowd,  attracted  thither  by  the  beauty  of  the 
scenery,  and  the  chime  of  its  bells,  which  recalled  the 
memories  of  distant  lands.  The  elevation  of  the  ground, 
with  its  gentle  slopes,  and  the  purity  of  the  air,  always 
freshened  by  the  sea  breeze,  indicated  this  place  as  an 
excellent  location  for  an  encampment.  Between  Saint 
George  and  Kamiesch,  the  French  cavalry  were  can- 
toned, and.  suffered  much  less  from  disease  than  the 
infantry,  because  the  place  ,of  habitation  was  more 
healthy;  the  personal  habits  of  the  cavalier  are  more 


22  THE   CRIMEAN   WAR. 

careful  than  those  of  the  foot  soldier ;  and  they  are  more 
in  open  air,  instead  of  being  squat  in  their  tents  a  large 
part  of  the  day. 

The  plain  of  Kamiesch  extends  to  Cape  Chersonesus, 
and  is  bordered  by  two  bays,  called  Kazak  and 
Kamiesch,  of  whose  existence  our  navy  were  at  first 
but  imperfectly  informed,  and  whose  discovery  was 
truly  fortunate.  They  were  constantly  filled  with 
vessels  coming  with  provisions  for  the  French  army, 
and  upon  these  naked  shores  of  easy  access,  enormous 
store-houses  for  provisions  were  erected,  while  the 
shanties  of  merchants,  more  or  less  respectable,  were 
grouped  each  day  more  thickly  around  our  military 
establishments.  In  a  few  months,  the  whole  city  had 
been  as  it  were  extemporised,  with  its  broad  and  regular 
streets,  its  coffee-houses,  its  theatre,  its  police,  its  Catholic 
church,  and  even  its  Protestant  temple.  I  have  not 
spoken  of  its  hospital,  but  this  was  well  arranged  and 
provided  for,  and  its  medical  service  was  skilfully  con- 
ducted. In  it  we  found  a  great  variety  of  diseases, 
because  the  men  who  were  placed  here,  were  found  too 
ill  for  the  time  being,  to  leave  for  the  hospitals  at  Con- 
stantinople. 

Kamiesch  is  almost  five  miles  from  Sebastopol;  and 
as  we  approach  it,  the  ground  is  found  thrown  up  by 
the  works  of  approach,  and  strewn  with  great  quantities 
of  projectiles.  These  lay  literally  in  piles,  in  the 
ravines  of  Carabelna'ia,  and  the  little  valley  where  the 
cemetery  of  Sebastopol  is  situated,  and  which  was  so 
often  taken  and  retaken  during  the  war.  Its  marble 
shafts  were  broken,  its  funereal  urns  dashed  to  pieces,  its 
wooden  crosses  mutilated,  and  its  tumulary  monuments 
overturned :  everything  was  devastated,  but  by  cannon 
alone,  for,  notwithstanding  the  intensity  of  the  cold, 
our  soldiers  respected  the  oaken  crosses  which  stood  over 
the  graves. 

N  othing  is  more  affecting  than  to  pass  around  a  city 
taken  after  a  long  and  bloody  siege.  Before  Sebastopol, 
there  were  seen  here  and  there,  immense  funnel-shaped 
pits,  which  had  been  made  by  the  fire  of  mines,  counter- 
mines, and  camouflets,  and  everywhere  we  met  trenches 


THE   CRIMEAN   WAR.  23 

for  ambuscade,  where  the  French  sharpshooters  lay  in 
wait  from  the  dawn  of  clay  till  night,  watching  the 
soldiers  and  officers,  and  the  artillerists  who  appeared 
on  the  fortifications,  or  showed  themselves  before  the 
cannon  embrasures.  At  length  the  latter  were  closed 
by  mats,  made  of  ropes  skilfully  braided  so  as  to  be 
bullet-proof.  At  times,  the  French  sharpshooters,  only 
fifty  yards  from  their  enemies,  would  draw  them  into 
conversation.  The  Russians  were  provided  with  ex- 
cellent half-boots,  of  which  they  knew  our  soldiers 
were  very  fond,  and  showing  the  point  of  their  feet  they 
would  call  out  in  good  French,  "  Venez  les  pi'endre."* 
It  may  be  certain  that  our  soldiers  were  not  slow  to 
reply,  nor  were  they  wanting  with  civil  words.  At 
another  time,  they  would  hold  up  over  the  battlements 
on  one  side  or  the  other,  a  bottle  or  a  flask,  and  the 
first  who  hit  the  object,  was  warmly  applauded  by  all 
the  marksmen.  There  was  no  hatred  between  the 
Russians  and  the  French ;  if  they  did  not  kill,  they 
embraced. 

In  entering  Sebastopol  by  the  Mat  bastion,  I  paid  a 
silent  homage  to  the  skill  of  General  Todtleben.  Be- 
fore me  arose  the  tower  of  Malakof,  and  the  Mamelon- 
Vert,  taken  on  the  7th  of  June,  1855.  The  formidable 
ramparts  of  the  latter,  were  raised  before  the  former, 
and  arrested  our  labors  of  approach,  until  after  a 
bloody  struggle  of  some  hours,  when  having  been  taken 
and  retaken  several  times,  it  remained  finally  in  our  pos- 
session. As  the  French  assailed  the  White  wrorks,  the 
English  gloriously  took  the  position  called  the  Quarries ; 
but  notwithstanding  the  skilful  arrangements  of  Gene- 
ral Pelissier,  we  approached  Sebastopol  but  about  four 
hundred  yards.  The  day  was  unhappily  saddened  by 
the  imprudent  ardor  of  the  regiments,  who  ran  up  to 
the  Malakof,  and  whose  heroic  courage  was  punished  by 
many  and  much  regretted  losses. 

I  visited  the  fortifications  of  Malakof,  a  true  laby- 
rinth of  Italic  S's  formed  in  relief  by  the  earth 
brought  up  from  the  subterranean  blinds,  and  the  arti- 

*  Come  and  take  them. 


24  THE   CRIMEAN   WAK. 

ficial  mounds  rising  each  day,  at  length  exceeded  the 
height  of  the  tower  itself.  During  the  last  days  that  pre- 
ceded the  assault,  the  besiegers  hurled  against  the  bastion 
6,000  bombs  every  twenty-four  hours.     The  Russians 
were   unable  to  come  out ;  in  burying  a  corpse,  they 
sacrificed  two  lives,  the  dead  were  therefore  oft  with- 
out  sepulture.     Meanwhile  their  casemates   sustained 
by  enormous  masts  taken  from  the  fleet,  and  covered 
with    many  yards  of  earth,  could   not  be  injured  by 
this  terrible  hail  of  projectiles ;  the  bastion  stood  out 
like  an  aerial  island  in  front  of  the  Mamelon-Vert.     On 
the  8th  of  September,  our  soldiers  entered  it  by  an  irre- 
sistible rush.     Nothing   could  stop  them;  neither  the 
broad  ditches  surrounding  it,  nor  the  high  parapets, 
bristling  with  bayonets  and  cannon,  nor  the  firm  hero- 
ism of  the   defenders.     Without  waiting  for  ladders, 
they  sprang  into  the  ditches,  and  climbed  the  parapets, 
by  mounting  upon  the  shoulders   of  their   comrades. 
These  positions   once   gained,  they  for  five  hours   de- 
fended them  against  the  vigorous  eiforts  of  the  Russian 
masses,  who  struggled  to  regain  their  lost  ground.  In  the 
absence  of  General  Todtleben,  detained  by  a  wound,  at  a 
distance  from  the  defensive  works,  the  Russians    had 
committed  the  very  serious  mistake  of  closing  the  gorge 
of  the  Malakof,  on  the  side  towards  the  city,  and  of  leav- 
ing only  a  narrow  passage,  through  which  their  columns 
could  not  deploy,  and  these  thrust  themselves  fruitlessly 
upon  the  bayonets  of  our  soldiers,  now  become  steady 
in  proportion  as  they  had  just  before  been  ardent  and 
enthusiastic.   The  enemy  had  depended  upon  an  electric 
wire,  leading  to  some  seventy  tons  of  powder,  to  bury  in 
the  ruins  of  the  bastion  the  besieging  army,  but  by  a 
happy  accident  the  blow  of  a  pick  exposed  the  wire,  and 
it  was  cut.     A  few  moments  after,  it  demolished  forts 
Paul  and  Alexander,  to  cover  the  retreat  of  the  Russians. 
Upon  this  day,  which  decided  the  war,  we  had  5  gene- 
rals killed,  4  wounded,  and  6  missing ;  24  superior  offi- 
cers killed;  20  wounded,  and  2  missing;  116  subaltern 
officers  killed,  224  wounded,  and  8   missing;  and  1,489 
non-commissioned    officers    and    soldiers    killed,    4259 
wounded,  and  1,400  missing.    Total  loss,  7,551. 


THE   CRIMEAN   WAR.  25 

The  district  occupied  by  the  allied  armies  was  about 
sixteen  leagues  in  circuit,  the  surface  mostly  uneven, 
and  cut  in  various  places  by  deep  ravines,  affording 
water  of  good  quality,  and  presenting  everywhere 
places  favorable  for  camp  and  military  operations. 
Upon  the  sides  of  the  mountains,  the  tents  of  the  allied 
armies  were  traced  in  rising  and  picturesque  outlines, 
and  iine  macadamized  roads,  built  and  kept  up  by  our 
troops,  afforded  facilities  for  transporting  provisions  and 
ammunition.  The  sheds  of  the  merchants  formed  small 
villages,  which  the  soldiers,  in  recognition  of  the  pro- 
bity of  these  industriels,  named  Pickpocketville,  Rogue- 
ville,  &G.  A  thoroughly  organized  police  inspected  the 
wines  and  brandies,  and  we  rarely  heard  complaints  of 
their  being  adulterated. 

The  climate  of  the  Crimea,  excepting  certain  marshy 
spots  that  might  be  easily  made  healthy,  is  remarkably 
salubrious,  and  excepting  the  cantonments,  which  the 
necessities  of  defence  exposed  to  the  paludal  influences 
of  the  Tchernai'a,  our  troops  were  in  good  hygienic  con- 
dition. The  heat  of  summer,  tempered  by  the  sea 
breeze,  scarcely  exceeded  that  of  the  south  of  France. 
The  winters  are  severe,  the  thermometer  sinking  —20° 
Centigrade  ( — 5°  Fahr.),  and  lower,  while  the  violence  of 
the  wind  renders  the  cold  very  hard  to  endure. 

Our  armies  found  but  few  resources  in  the  country, 
and  the  Tartars  could  only  sell  some  cattle,  sheep,  chick- 
ens, and  eggs.  They  were  as  greedy  in  a  bargain  as  the 
merchants  we  have  mentioned,  and  I  have  seen  them, 
ask  five  francs  for  a  hundred  walnuts — and  they  found 
customers  too.  We  carefully  respected  their  villages,  dis- 
turbed nothing,  and  maintained  good  relations  with 
them.  The  wood  which  covered  the  hills  quickly  disap- 
peared, and  in  the  winter  of  1856  the  roots  of  the 
stumps  themselves  were  dug  up.  We  have  read  of  the 
passage  of  locusts  in  eastern  countries,  but  the  presence 
of  an  army  is  a  scourge  even  more  sweeping ;  for  the 
former  devour  only  what  is  upon  the  surface  of  the  earth. 
The  distance  of  over  twelve  miles,  prevented  us  from 
turning  to  profit  the  rich  forest  of  Baidar,  and  the  ad- 
ministration found  it  easier  and  quicker  to  bring  its 


26  THE    CRIMEAN   WAR. 

wood  from  Varna.  After  the  taking  of  Sebastopol,  the 
wood  employed  in  the  defences  was  largely  used  in  the 
kitchens  of  the  regiments,  while  the  troops  adjacent  to 
Baidar,  alone,  continued  to  obtain  its  wood  from  the 
forest,  by  the  aid  ofarabas  and  oxen,  which  the  author- 
ities placed  at  their  disposal.  These  arabas  are  the 
wagons  of  the  country,  clumsy  and  entirely  of  wcocl, 
not  a  particle  of  iron  being  used  about  them.  They 
encumbered  the  road  to  Voronzof,  and  the  creaking  of 
their  wheels  Avas  music  to  the  ears  of  the  Tartars.  The 
Russians  brought  in  their  provisions  upon  arabas,  dra\vn 
by  oxen,  and  upon  their  arrival,  the  cattle  were  slaugh- 
tered, and  the  wood  of  the  chariots  served  to  cook 
them. 

About  six  miles  from  Kamiesch,  upon  a  hill,  in  the 
midst  of  the  French  army,  were  the  general  headquar- 
ters, and  there  was  the  modest  little  tent,  in  which  General 
Canrobert  passed  the  winter  of  1855,  having  given  up, 
for  the  use  of  the  hospitals,  the  temporary  barrack 
destined  for  the  use  of  the  Commander-in-chief.  He 
wished  to  share  with  his  men  the  rigors  of  the  season. 
This  example  of  self-denial  in  a  high  station,  infused  a 
heroic  spirit  through  every  rank ;  but  not  by  this  alone, 
but  by  many  other  honorable  and  ingenious  devices, 
did  the  General-in- chief  seek  to  sustain  the  spirit  of  the 
army,  through  the  rudest  vicissitudes  of  their  duties. 
Upon  the  highest  point  of  the  General's  quarters, "there 
was  built  a  clock  tower,  of  stone,  and  the  clock,  with  its 
dials,  taken  from  a  belfry  in  Sebastopol,  served  to  regu- 
late the  time  of  their  watches.  Around  the  quarters  of 
Marshal  Pelissier  were  grouped  the  offices  of  the  postal 
service,  the  treasury,  the  electric  telegraph,  the  chief 
chaplain,  the  little  extemporized  church,  where  mass 
was  said,  and  in  short,  all  the  chief  departments  of  the 
service. 

I  soon  entered  into  the  details  of  the  camps,  regi- 
ments, regimental  infirmaries,  and  the  field  and  regu- 
lar hospitals,  and  consulted  the  generals,  supervisors, 
chiefs  of  departments,  and  physicians,  to  learn  the  wants 
of  the  soldier,  and  fix  my  ideas  concerning  measures 
relative  to  rations,  shelter,  and  clothing. 


THE   CRIMEAN   WAR.  27 

On  the  20th  of  October,  I  addressed  to  the  Minister 
of  War  the  following  report : — 

"  To  His  EXCELLENCY  THE  MARSHAL. — I  have  devoted 
the  first  days  after  my  arrival  in  the  Crimea,  to  visiting 
the  field  hospitals  of  Divisions,  to  examining  the  camps, 
and  to  the  study  collectively  of  the  great  questions  of 
hygiene,  implied  in  the  very  important  mission  which 
your  Excellency  has  deigned  to  intrust  to.  me. 

"I  am  now  able  to  express  an  opinion  upon  some  of 
these  points,  and  I  can  with  pleasure  affirm,  that  the 
health  of  our  troops  was  never  better.  In  the  Crimea, 
as  at  Constantinople,  half  of  the  beds  in  the  hospitals 
are  unoccupied,  while  the  transmission  of  the  sick  has 
nearly  ceased.  We  have  neither  cholera  nor  typhic 
fever — dysenteries  are  rare,  and  the  scurvy  is  less 
intense.  The  hospital  gangrene  has  begun  to  disappear, 
wounds  assume  a  better  aspect,  and  every  day  numbers 
of  the  wounded  leave  the  field  hospitals,  to  return  to 
their  regiments,  or  to  their  families,  to  await  a  formal 
discharge  from  the  service. 

"  The  beauty  and  salubrity  of  climate,  the  taking  of  Se- 
bastopol,  the  elevated  tone  of  military  spirit,  the  constant 
watchfulness  of  the  Commander,  the  wise  measures 
adopted  by  the  military  intendants,  and  the  skill  and 
devotion  of  the  medical  corps,  are  praised  by  all,  and 
have  led  to  these  happy  results. 

"  The  field  hospitals  of  Divisions  are  well  adapted  to 
their  purpose,  and  each  of  them  will  accommodate  750 
sick,  sheltered  by  temporary  barracks  or  tents.  The 
rations  of  food,  as  a  general  thing,  leave  nothing  to  be 
desired;  and  if  the  bread  is  sometimes  too  damp,  or  a 
little  burnt,  it  is  explained  by  the  difficulty  of  dealing 
out  fresh  bread  every  day,  in  a  country  where  every- 
thing has  to  be  brought,  even  to  the  wood;  while  as  an 
offset,  the  wine  is  of  superior  quality,  and  is  served  at 
the  table  of  the  soldier,  the  same  as  to  that  of  the  gene- 
ral. The  preserved  vegetables  have  done  us  much  ser- 
vice, and  milk  concentrated  by  the  method  of  Lignac 
has  been  tried  with  satisfactory  results.  This  mode  of 
supply  is  the  only  one  possible  at  this  time,  and  would 
be  of  great  use  in  our  hospitals  in  the  Crimea,  and  even 


28  THE   CRIMEAN   WAK. 

at  Constantinople,  where  milk  is  scarce,  of  very  poor 
quality,  and  of  high  price. 

"  If  the  whole  army  should  winter  in  the  Crimea,  there 
would  be  an  absolute  necessity  of  changing  without 
delay,  the  field  hospitals  of  divisions  into  temporary 
hospitals.  It  would  be  sufficient  to  increase  the  number 
of  shanties,  to  abandon  the  tents,  so  precious  in  sum- 
mer, and  to  furnish  the  shanties  with  furniture,  bedding, 
and  utensils  of  every  kind  necessary.  Hospitals  for  6000 
sick,  together  with  the  regimental  infirmaries,  would 
supply  the  wants  of  the  army ;  and  the  sending  of 
patients  to  Constantinople,  which  until  now  has  been 
so  frequent,  often  so  unpleasant  to  the  sick,  especially 
in  rough  weather,  and  always  so  burdensome  to  the 
treasury,  would  be  necessary  only  in  exceptional  cases. 
The  hospitals  at  Constantinople,  which  so  greatly  need 
to  be  purified  by  rest,  would  thus  become  a  reserved 
resource  for  secondary  use,  and  a  part  of  their  attend- 
ants and  furniture  might  be  sent  to  the  Crimea.  It 
would  be  wise  to  construct  near  the  monastery  of  Saint 
George  or  at  Constantinople,  an  extensive  depot  for 
convalescents ;  for  it  is  of  first  importance  to  put  an  end 
to  these  emigrant  fleets.  The  best  way  to  restore  a 
moral  tone,  and  put  an  end  to  longings  for  the  domestic 
fireside,  natural  enough  to  the  men,  but  enervating  to 
the  army,  is  to  cut  short  this  idea  of  sending  oif  the 
sick,  which  I  believe  has  been  greatly  abused,  since,  out 
of  every  hundred  sick  taken  to  Marseilles,  only  ten  had 
need  to  enter  the  hospital.  We  might  with  little 
expense  construct  here  ample  barracks  for  the  sick.  The 
walls  might  be  made  of  biscuit  boxes  filled  with  earth, 
and  laid  one  upon  another,  or  by  the  use  of  casks,  or 
the  fascines  used  in  the  siege,  which  might  be  laid  up  in 
a  few  hours,  and  covered  with  a  roof  of  boards.  This 
system  of  protection  against  the  rain,  snow  and  cold  of 
winter,  might  be  extended  to  the  whole  army ;  there 
would  be  no  lack  of  fascines,  and  if  boards  are  wanting, 
they  can  use  their  tents  for  the  roofs. 

u  The  imperious  exigencies  of  the  long  and  glorious 
siege  of  Sebastopol  have  happily  ended,  and  though  we 
still  hear  the  thunder  of  cannon,  the  bullets  are  almost 


THE   CRIMEAN   WAE.  29 

harmless,  and  the  time  has  come  when  we  should  be 
actively  employed  with  measures  for  sheltering  from  the 
rigors  of  winterxthe  soldiers,  to  whose  heroism  France, 
which  honors  every  kind  of  merit,  will  hereafter,  with- 
out doubt,  raise  one  day  an  imperishable  monument.'' 

Pursuing  my  inquiry,  I  resolved  to  inform  myself 
correctly  on  all  points,  to  seek  the  means  for  warding 
off  the  dangers  which  the  approaching  winter  threat- 
ened us  with,  and  to  ascertain  the  truth,  from  the 
varied  and  often  contradictory  opinions  which  were 
expressed  upon  these  important  questions. 


CHAPTER  II. 
•RATIONS. 

IN  my  investigations  concerning  the  provisioning  of 
the  army  of  the  East,  four  principal  classes  were  indi- 
cated by  the  nature  of  the  alimentary  substances  them- 
selves, and  I  have  examined  successively,  the  facts  con- 
cerning bread,  meats,  vegetables,  and  drinks. 

Biscuit,  which  is  the  bread  of  mariners,  was  of  great 
reliance  in  our  Crimean  army.  It  is  easily  kept,  if  free 
from  moisture,  is  easily  carried,  and  weight  for  weight 
is  much  more  nourishing  than  army  bread.  The  water 
which  bread  contains,  increases  its  weight  a  third  part, 
while  none  of  this  remains  in  biscuit.  Flour,  when  made 
into  biscuit,  is  lightened  five  per  cent.  The  biscuits  from 
France  were  good,  while  those  from  Constantinople 
were  not  always  of  faultless  quality,  and  sometimes 
contained  traces  of  moisture. 

The  usual  ration  of  biscuit,  was  550  grammes  (1.21 
pounds),  besides  185  grammes  (0.4  pounds)  in  the  soup. 

At  the  opening  of  the  campaign,  the  ration  was  in- 
creased to  650  grammes  (1.43  pounds),  and  when  the 
troops  labored  in  the  trenches,  they  received  daily  per 
man  an  increase  of  half  a  franc  in  pay,  and  of  250 


30  THE   CRIMEAN   WAB. 

grammes  (0.55  pounds)  of  biscuit.  Still,  the  soldiers 
preferred  army  bread,  though  heavy  and  coarse,  to  the 
best  of  biscuit,  as  the  former  digests  more  slowly,  lies 
better  on  the  stomach,  and  never  leads  to  satiety  and 
disgust.  Biscuit,  without  leaven,  is  extremely  absor- 
bent, acting  in  the  stomach  like  a  sponge,  and  after 
having  exhausted  the  salivary  glands  in  mastication,  it 
absorbs  the  gastric  juice,  so  that  not  enough  remains 
fbr  proper  digestion.  For  the  purpose  of  softening 
it,  they  soak  it  for  a  moment  in  water,  and  then  hold 
it  to  the  fire,  by  which  it  becomes  pasty,  insipid,  and 
indigestible.  Biscuit  should  therefore  not  be  distri- 
buted, unless  bread  is  wanting.  Very  often  half  rations 
of  bread  are  given,  and  during  the  Crimean  campaign 
four  distributions  in  seven,  were  of  biscuit.  It  is  no 
easy  task  to  furnish  fresh  bread  to  an  army  of  140,000 
men,  when  it  is  necessary  to  bring  from  beyond  seas,  the 
flour,  the  wood,  the  kneading  troughs,  and  the  ovens. 

In  Paris,  the  baker's  civil  tax  is  based  upon  the  pro- 
portion of  130  pounds  of  bread  to  100  pounds  of  flour, 
this  ratio  between  the  quantity  of  flour  and  water  which 
it  should  absorb,  being  recognised  as  necessary  for  the 
proper  preservation  of  the  bread.*  The  war  depart- 
ment imposes  no  limit,  and  the  highest  ratio  is  the  best. 

*  In  the  American  army,  the  regulations  allow,  under  ordinary  cir- 
cumstances, the  issue  of  flour  at  the  rate  of  22  ounces  daily  to  each 
man,  in  place  of  the  same  weight  of  bread.  This  flour,  drawn  by  the 
Division,  Brigade,  Regiment,  or  Post,  is  baked  by  soldiers  detailed  for 
the  purpose,  in  ovens  made  of  sheet  iron,  covered  with  brick,  stone,  or 
earth,  or  hi  ovens  of  brick  alone,  and  the  savings  that  result  go  to- 
wards establishing  a  fund  for  the  benefit  of  the  posts  or  regiments 
concerned.  There  are  probably  no  regiments  in  the  service,  in  which 
a  sufficient  number  of  masons  and  bakers  could  not  be  found,  to  con- 
struct and  operate  these  bakeries.  For  purposes  of  economy,  they  are 
often  worked  day  and  night,  by  relays  of  men.  Ttie  savings  have  in 
some  cases  exceeded  33  per  cent.,  and  will,  in  most  if  not  all,  come  up 
to  30  per  cent.  The  economy  of  the  arrangement  appears  in  the 
difference  of  transportation,  and  in  the  quality  of  the  bread,  as  well  as 
in  the  savings  upon  weight,  and  the  facility  with  which  negligence 
and  abuses  can  be  corrected,  is  so  great,  that  they  may  be  checked 
upon  first  appearance.  In  G-en.  Kearney's  Brigade,  of  four  regiments 
in  Franklin's  Division  of  the  army  of  the  Potomac,  the  savings  in  two 
months,  in  the  winter  of  1861-2,  amounted  to  $3,436. — TE. 


THE    CRIMEAN   WAR.  31 

With  tender  wheat,  144  pounds,  aftid  with  hard  wheat, 
150  pounds  to  100  of  flour,  can  be  attained;  but  bread 
too  much  charged  with  water,  bakes  badly,  the  crust 
burns  and  blackens,  it  soon  softens,  loses  its  fermenta- 
tion, and  yields  a  food  more  or  less  defective.  Perhaps 
bread  made  a  half  or  a  quarter  biscuit,  with  a  little 
leaven,  should  be  prepared  for  armies  in  the  field.  The 
ration  would  be  less  in  weight,  but  not  less  nutritious, 
and  it  would  obviate,  to  a  considerable  degree,  the  incon- 
veniences of  biscuit. 

The  bolting  of  flour  for  army  bread,  has  for  some  time 
been  carried  as  far  as  20  per  cent,  of  bran  extraction,  for 
tender  wheat.  It  was  thought  the  less  bran  there  was  in 
bread,  the  more  nutritious  it  would  be,  and  that  the 
whiter  it  could  be  made,  the  more  it  could  be  used  for 
soups,  instead  of  bread  bought  from  the  civil  bakeries,  in 
which  the  bolting  is  carried  to  40  per  cent,  of  bran.  This 
innovation  does  not  seem  to  be  wise,  for  it  raises  the  cost 
without  a  corresponding  advantage.  The  new  kind  of 
bread  digests  too  rapidly,  and  does  not  mix  well  in  soups. 
It  is  not  shown  that  bran,  within  certain  limits,  does  not 
contain  elements  capable  of  assimilation,  and  in  times 
of  scarcity  or  war,  it  is  a  thing  of  no  small  consequence, 
to  carry  the  bolting  of  bran  to  such  an  extent  for  an 
army  of  500,000  men.  Besides,  our  soldiers  are  chiefly 
from  the  rural  districts,  and  would  prefer  bread  of  infe- 
rior quality,  such  as  they  have  been  accustomed  to, 
rather  than  the  whiter  bread  of  our  army  supplies. 
Our  Russian  prisoners,  accustomed  to  a  very  coarse 
bread,  were  not  sufficiently  nourished  by  the  bread  fur- 
nished to  our  soldiers,  and  required  increased  rations. 

The  best  fresh  meat  is  beef.  Alone  it  makes  a  good 
soup,  and  according  to  a  saying  as  true  as  it  is  common, 
soup  makes  the  soldier.  Our  cattle  arrived  in  the  Crimea 
after  such  long  vicissitudes,  that  they  might  be  said  to  be 
as  lean  as  Pharaoh's  kine,  and  in  order  that  the  quantity 
might  make  up  for  the  quality,  the  ration  was  increased 
from  250  to  300  grammes  (0.55  to  0.66  pounds),  but  the 
bones,  which  were  included,  were  of  great  relative 
weight.  I  recommended  that  the  hard  parts,  after 
having  been  boiled  in  the  pot,  should  be  pounded  up 


32  THE   CRIMEAN   WAR. 

and  boiled  again,  to  extract  the  'gelatine ;  and  this 
method,  as  employed  in  the  hospitals  at  Constantinople, 
very  sensibly  improved  the  broths  of  the  sick,  and  we 
were  able  to  order  it  as  a  regular  prescription  to  the 
regimental  and  hospital  cooks.  In  France,  it  is  true, 
bones  are  -sold,  but  here,  would  they  be  worth  what  it 
would  cost  to  take  care  of  them  ? 

When  fresh  meat  was  wanting,  it  was  replaced  by 
preserved  dressed  meat,  put  up  in  tin  cans  hermetically 
sealed,  and  as  it  contained  no  bones,  the  ration  was  re- 
duced to  120  grammes  (0.25  pounds).  These  preserved 
meats  were  of  excellent  quality,  but  the  soldiers  disliked 
the  change,  for  they  estimated  the  weight  and  bulk  more 
than  the  quality,  and  although  the  quarter  of  a  pound 
fed  them  really  as  much,  they  declared  it  insufficient, 
and  preferred  fresh  meat,  even  of  poor  quality.  Some- 
times the  ration  was  sausage  and  lard,  and  occasionally 
packages  of  powdered  meat.  The  latter  was  eaten  by 
few,  was  liable  to  adulteration,  had  a  suspicious  odor, 
and  the  men  were  always  in  doubt  whether  animals  of 
all  kinds  were  not  used  in  its  manufacture.  After  a 
few  days'  use,  the  troops  manifested  a  great  repugnance 
and  disgust  towards  it. 

The  sheep,  which  contrived  to  find  a  few  blades  of 
grass,  although  insufficient  for  the  sustenance  of  cattle, 
were  kept  in  good  condition,  and  were  highly  prized. 
A  great  number  of  horses  died  during  the  winter  of 
1855-6,  and  following  the  example  of  the  distinguished 
savan,  M.  Isidore  Geoffroy  Saint  Hilaire,  I  preached  the 
doctrine  of  eating  horse  flesh,  but  made  few  converts. 
The  horse  is  herbivorous,  like  the  ox ;  no  animal  is  more 
neat,  it  is  washed  and  cleaned  daily ;  its  flesh,  although 
more  firm,  is  not  less  satisfying,  and  it  would  make 
excellent  soups.  In  Germany,  horse  flesh,  cut  up,  is  sold 
publicly  in  the  butchers'  stalls.  The  two  artillery  batte- 
ries of  Autemarre's  division,  encamped  at  Baidar,  fed 
upon  horse  flesh ;  nor  did  they  have  reason  to  regret  it, 
as  they  escaped  the  diseases  and  mortality  which  swept 
so  cruelly  through  the  rest  of  the  army.  Experiments 
made  by  very  competent  savans  have  proved,  that 
horse  flesh,  even  tainted,  as  in  the  black-tongue,  when 


THE   CRIMEAN   WAK.  33 

purified  by  fire,  may  be  eaten  without  danger,  but  still, 
I  would  not  venture  to  advise  the  eating  of  diseased 
horses.  I  know  that  the  meat  of  oxen,  flaccid,  colorless, 
and  gluey,  which  we  were  sometimes  forced  to  distribute 
in  times  of  scarcity-,  has  caused  diarrhoeas.* 

Fish,  and  especially  the  buckle  turbot,  are  abundant 
on  the  coasts  of  the  Crimea ;  and  while  butchers'  meat, 
even  of  poor  quality,  sold  at  Kamiesch  at  a  quarter  of 
a  dollar  a  pound,  a  turbot  of  ten  pounds  cost  only 
seventy-five  cents  or  a  dollar.  After  the  taking  of  Se- 
bastopoli  the  officers,  with  nets  found  in  the  city,  made 
wonderful  hauls  of  fish  in  the  bay  of  Streteska.  I  regret 
that  we  were  unable  to  establish  large  fisheries,  to  con- 
tribute by  this  precious  resource  to  the  support  of  our 
army,  and  aiford  variety  to  its  food.  We  also  found 
excellent  game,  quails  and  woodcock,  at  the  time  of 
their  migration,  and  hares,  pheasants,  and  roebucks 
in  the  forest  of  Baidar.  The  feast  of  St.  Hubert  was 
held  in  the  forest.  It  is  needless  to  say,  that  the  luxu- 
ries did  not  go  to  the  soldiers'  tables.  Some  of  the 
officers  kept  fowls  for  their  eggs. 

The  want  of  fresh  vegetables  for  our  army  was  a  great 
privation.  Preserved  vegetables  were  never  wanting; 
and  the  mixed  kinds,  which  we  distributed  very  regu- 
larly, were  the  most  relished  of  all.  At  the  end  of  the 
campaign,  these  preserves  were  of  poor  quality,  and 
were  found  sometimes  so  altered  by  fermentation  that 
the  soldiers  threw  them  away.  The  avidity  of  the 
dealers  was  not  checked  by  the  miseries  of  the  army,  and 
tended  greatly  to  increase  them.  The  sacks  of  potatoes 
received  from  time  to  time,  wrere  very  acceptable.  The 
government  delivered  them  at  the  rate  of  three  cents 
the  pound,  but  in  the  shops  at  Kamiesch  they  were  sold 

*  Under  favorable  circumstances,  cattle  are  issued  to  the  American 
army  upon  hoof,  their  weight  being  determined  by  the  following  rule : 
From  the  live  weight  of  a  steer,  there  is  deducted  45  per  cent,  when 
the  gross  weight  exceeds  1300  pounds,  and  50  per  cent,  when  it  is  less 
than  that,  and  not  under  800  pounds.  When  pasturage  or  forage  are 
abundant,  the  post  or  regiment  may  often  realize  a  valuable  saving, 
both  in  quality  and  quantity,  by  allowing  their  cattle  to  recruit  from 
the  exhaustion  of  a  long  journey  by  railroad  and  to  gam,  flesh  by 
feeding. — TB. 


34  THE    CRIMEAN  WAR. 

at  from  nine  to  twenty-five  cents.  For  cabbages,  as 
much  as  $1.86  were  paid.  Man  has  need  of  vegetables 
as  muck  as  of  meat.  Physiologists  divide  alimentary 
substances  into  two  classes ;  nitrogenous,  which,  accord- 
ing to  Dumas,  supply  the  demands  of  assimilation,  and 
non-nitrogenous,  which  furnish  the  products  consumed 
by  respiration,  and  are  called  by  Liebig  respiratories. 
The  wrant  of  vegetables,  which  belong  chiefly  to  the 
latter  class,  impairs  the  respiratory  function,  and  injures 
by  hematosis.  It  has  been  demonstrated,  that  the  ulti- 
mate effect  of  this  regimen  would  be  death. 

The  necessity  of  a  varied  nourishment  has  been  esta- 
blished as  a  practical  fact.  The  theoretical  views  by 
which  it  has  been  attempted  to  account  for  this  neces- 
sity, do  not  seem  to  accord  with  the  facts  observed  in 
late  years.  The  need  of  a  varied  food  is  recognised; 
explanations  of  the  effects  of  the  food,  alone,  ought 
to  be  abandoned.  They  are  based  upon  very  attractive 
views,  w7hich,  recognising  in  vegetables  the  power  of 
supplying  the  chemical  elements,  as  oxygen,  hydrogen, 
and  nitrogen,  or  the  simple  compounds,  as  water  and 
carbonic  acid,  and  of  making  from  these  elements,  what 
organic  chemists  call  the  proximate  principles,  as  ami- 
don,  sugar,  gluten,  etc.,  deny  to  the  animal,  the  power 
of  fabricating  these  proximate  principles.  They  seem 
to  think,  that  animals  should  become  the  borrowers  of 
the  food  ready  prepared,  and  that  they  should  limit 
their  role  to  its  assimilation.  It  is  now  proven  by  the 
beautiful  experiments  of  M.  Claude  Bernard,  on  the  for- 
mation of  sugar  by  the  liver,  in  animals  fed  exclusively 
upon  meat,  that  they  can  manufacture  proximate  prin- 
ciples, as  well  as  vegetables  can.  Furthermore,  in  show- 
ing, that  instead  of  the  blood's  warming  in  the  lungs, 
it  actually  becomes  cooler,  M.  Bernard  has  rendered 
inadmissible  the  hypothesis,  which  wrould  make  this 
organ  the  seat  of  combustion,  arising  from  the  combus- 
tion of  atmospheric  oxygen  with  the  carbon  of  venous 
blood. 

Desiccated  vegetables,  having  lost  their  water  of  vege- 
tation, and  perhaps  other  gaseous  elements,  which  analysis 
has  not  been  able  to  discover,  cannot  adequately  replace 


TUE   CRIMEAN   WAK.  35 

the  fresh  articles.*  In  the  army  of  the  East,  the  imper- 
fect aeration  of  the  blood  could  be  traced  in  sanguineous 
effusions,  and  in  scurvy.  As  to  food  and  habitation,  the 
Crimean  expedition  might  perhaps  be  compared  to  a 
long  voyage ;  the  army  being,  as  it  were,  limited  to  a 
great  ship,  and  subjected  to  the  influences  of  navigation 
on  a  vast  scale.  Prolonged  habitation  in  common,  gene- 
rated noxious  exhalations,  and  finally  typhus.  The 
invasion  of  scurvy  was  delayed  by  the  presence  of  a 
plant,  as  precious  as  it  was  abundant,  the  Terrassa- 
cum  of  Linnaeus,  commonly  known  as  the  dandelion. 
As  the  trees  and  their  roots  were  removed  from  the  soil 
of  the  Crimea,  this  plant  became  the  king  of  vegetation. 
The  Crimea  was  the  Promised  Land  of  the  Terrassacum. 
It  resisted  bravely  the  destructive  war  which  our  sol- 
diers waged  upon  it ;  torn  up  without  stint,  it  sprang 
up  again  in  still  greater  profusion.  It  made  a  salad 
of  easy  digestion,  and  with  a  pleasant  and  salutary  bit- 
terness. It  appeared  daily  on  the  table  of  Marshal  Pe- 
lissier,  with  whom  it  was  a  great  dainty.  Unfortunately, 
in  the  heart  of  winter,  and  middle  of  summer,  the  ex- 
tremes of  cold  and  heat  checked  the  growth  of  this  use- 
ful plant,  and  its  disappearance  was  followed  by  the  deve- 
lopment of  scurvy. f  The  Minister  of  War  caused  to 
be  purchased  in  the  markets  of  Constantinople,  large 
quantities  of  fresh  vegetables.  One  of  my  reports  says, 
"  100,000  francs,  spent  in  fresh  vegetables,  is  a  saving 
of  500,000  francs  in  the  expense  of  sending  the  sick  to 

*  The  desiccated  vegetables  furnished  to  the  American  army,  have 
in  many  cases  fallen  into  disrepute,  from  the  faulty  manner  in  which 
they  have  been  cooked.  The  error  has  generally  consisted  in  omitting 
to  soak  them  thoroughly  beforehand,  in  not  boiling  them  for  a  suffi- 
cient length  of  time,  and  in  putting  them  into  soups  in  too  great  quan- 
tities. When  thoroughly  soaked,  sufficiently  boiled,  and  properly 
seasoned,  they  are  generally  relished.  The  American  army  in  Utah 
owed  their  preservation  from  scurvy  largely  to  the  use  of  these  desic- 
cated vegetables,  at  a  tune  when  nothing  else  of  an  antiscorbutic  kind 
could  be  obtained. — Tn. 

f  Among  the  antiscorbutics  used  with  success  by  the  army  of  the 
United  States,  in  western  expeditions,  have  been  agave  juice,  wild 
artichokes,  lamb-lettuce,  wild  onions,  the  tender  shoots  of  the  Phyto- 
lacca  decandra  or  pokeweed,  nettles,  celery,  and  wild  oranges.  Kaw 
potatoes,  sliced  in  vinegar,  are  highly  useful. — TE. 


36  THE   CRIMEAN   WAR. 

hospitals.''  Towards  the  close  of  our  sojourn,  we  made 
kitchen  gardens,  and  raised  some  few  things  of  first 
necessity.  They  promise  great  resources  in  the  future, 
should  we  remain  in  a  country  so  destitute  of  every- 
thing. I  am  surprised  that  the  army  was  not  furnished 
with  sour  krout,  which  is  so  easy  to  keep.  Lentils  were 
scarce,  but  kidney  beans  plenty. 

Vegetable  acids,  that  is  apples,  lemons,  and  oranges, 
were  wanting.  These,  as  we  know,  are  antiscorbutic. 
The  English  drew  rations  of  lemon  juice  preserved  in 
casks,  and  they  used  it  in  their  grog,  with  rum  and  sugar. 
Our  field  hospitals  and  regimental  infirmaries  were  well 
provided  with  it  towards  the  close  of  the  campaign,  but 
our  experience,  although  attended  with  good  results, 
was  not  sufficiently  tried  to  render  it  fully  conclusive. 
The  English  physicians  ascribe  great  antiscorbutic  vir- 
tues to  the  lemon  juice,  and  say  it  is  in  a  large  degree 
owing  to  its  use  that  their  army  was  saved  from  the 
scurvy,  in  the  winter  of  1856.  It  has  for  a  long  time 
been  valued  as  an  antiscorbutic  by  their  mariners,  who 
take  it  with  them  on  long  voyages. 

Soup  is.  excellent  food  for  the  soldier,  but  its  quality 
depends  much  upon  the  cook.*  Every  soldier  takes  his 
turn  in  cooking,  as  he  does  in  mounting  guard ;  but 
this  is  wrong.  In  the  same  regiment,  some  companies 
eat  good  soup,  and  some  bad.  The  army  officers  do 
not  usually  trouble  themselves  with  these  details,  so 
important — for  the  first  condition  of  health  is  that  the 
stomach  be  satisfied.  In  the  Crimea,  the  troops  that 
best  sustained  privations  and  fatigues,  were  those  com- 
manded by  colonels  careful  of  their  men.  Let  us  take 
an  example  of  two  regiments,  which  left  the  camp  of 

*  In  the  American  service,  the  several  companies  of  a  regiment  are 
provided  with  kettles  and  fixtures  for  cooking  by  companies,  a  coos. 
and  one  or  more  assistants  being  detailed  or  hired  for  each  company. 
Probably  this  service  is  never  better  performed,  than  where  an  expe- 
rienced cook  is  steadily  employed,  and  the  assistants  are  changed  at 
short  intervals.  By  this  arrangement,  nearly  every  man  in  the  com- 
pany will  have  an  opportunity  of  acquiring  that  culinary  experience 
which  would  enable  him,  if  detached  from  the  company,  and  thrown 
upon  his  own  resources,  to  prepare  his  food  in  a  manner  consistent 
with  the  preservation  of  health. — TE. 


THE   CRIMEAN   WAR.  37 

Saint  Omer  at  the  same  time,  arrived  together  in  the 
Crimea,  in  October,  1855,  encamped  side  by  side,  en- 
dured the  same  vicissitudes  of  weather,  and  performed 
the  same  services ;  the  one  preserved  on  the  1st  of  April, 
1856,  2,224  soldiers  of  an  effective  force  of  2,676  men, 
while  the  other,  with  an  effective  force  of  2,327  men, 
had  1,239  only  left — and  these  losses  did  not  include  those 
wounded  in  the  war !  In  the  armed  naval  service,  our 
commanders  of  vessels  supervise  the  preparation  of  meals 
for  the  crews,  and  observe  most  punctually  the  hour  for 
breakfast  and  dinner,  which  is  never  delayed,  antici- 
pated, or  interrupted.  It  is  earnestly  to  be  wished,  that 
the  same  scrupulous  care  might  find  its  way  into  our 
land  armies,  and  that  these  wise  hygienic  measures 
should  never  be  infringed  upon,  except  in  cases  of  abso- 
lute and  manifest  necessity.  We  pay  rewards  to  those 
colonels  of  cavalry  whose  squadrons  preserve  the  great- 
est number  of  horses,  and  these  rewards  excite  an  excel- 
lent and  profitable  emulation.  We  could  have  similar, 
but  more  important  and  happy  results,  were  we  to  grant 
similar  tokens  to  colonels,  whose  battalions  preserved 
the  most  men  in  the  best  health. 

Wine  does  not  form  a  part  of  the  ordinary  rations  of 
the  soldier  in  a  campaign.  That  which  was  distributed 
to  the  army  of  the  East  was  generally  good.  Each 
soldier  drew  half  a  pint,  and  officers  were  allowed  to 
take  daily  from  the  stores,  besides  their  rations,  a  litre 
(0.264  gallon)  of  wine,  for  which  he  paid  fifteen  cents, 
while  the  private  dealers  sold  wine  for  three  or  four 
times  that  sum.  During  the  epidemic,  Marshal  Pelis- 
sier  doubled  the  rations.  For  our  sick,  we  had  gene- 
rous wines,  which  the  administration  gave  liberally. 
Brandy  alternated  with  the  wine,  the  ration  being 
about  a  third  of  a  pint.  Taken  immoderately,  brandy 
is  very  dangerous  in  winter,  and  exposes  the  drunkard 
to  perish  from  cold ;  but  in  moderation  it  excites  a  salu- 
tary reaction.  M.  Laurent,  a  ship  lieutenant,  with  some 
marines,  had  charge  clay  and  night  of  a  battery  before 
Sebastopol ;  he  preserved  the  health  of  his  cannoneers 
through  the  winter  by  giving  them,  at  stated  intervals 
during  the  night,  three  warm  grogs  of  brandy,  through 


38  THE   CRIMEAN   WAE. 

which  the  system  gained  great  power  to  resist  the  cold. 
Coffee  was  often  given  out  instead  of  wine  or  brandy, 
the  rations  consisting  of  sixteen  grammes  (about  half 
an  ounce)  of  coffee,  and  twenty-one  grammes  (three- 
fourths  of  an  ounce)  of  sugar.  During  the  early  cam- 
paign in  Algeria,  the  columns  about  to  be  sent  out 
received  advance  rations  of  brandy  for  eight  days, 
which  were  consumed  before  starting.  The  drunken- 
ness which  ensued  was  a  lamentable  prelude  of  the 
fatigues  and  privations  of  the  war ;  and  at  the  time 
of  the  expedition  to  Mascara,  in  1834,  it  was  necessary 
to  send  to  the  field  hospitals  a  host  of  soldiers  attacked 
with  dysentery.  Upon  setting  out  upon  the  expedition 
of  Tlemcen,  I  advised  the  substitution  of  coffee  for 
brandy,  and  with  very  decisive  results.  Coffee  has 
become  among  our  soldiers  in  campaign  a  healthful  and 
favorite  drink,  and  is  found  to  prevent  the  intestinal 
looseness  so  frequent  in  warm  climates.  The  Arabs 
take  daily,  several  light  infusions  of  coffee,  and  when  in, 
their  country,  we  ought  to  be  governed  by  their  tradi- 
tional usages,  founded  upon  reason.  The  soldier,  by 
steeping  some  pieces  of  biscuit  in  his  coffee,  makes  at 
will  a  very  nutritious  soup,  of  which  he  never  gets 
tired.  Coffee  is  especially  useful  on  a  halt,  or  in  the 
trenches,  and,  in  short,  anywhere  when  the  soldier  has 
not  time  to  prepare  his  soup.  It  refreshes  and  enlivens, 
while  it  does  not  prevent  sleep  after  a  day  of  fatigue  in 
the  open  air.  It  recommends  itself  to  the  government, 
being  easily  kept  and  carried.  It  should  not  be  ground 
long  before  use,  because  it  then  loses  its  volatile  aromatic 
principles.  It  may  be  roasted  and  distributed  in  the 
grain.  In  the  Crimea,  we  gave  the  troops  little  mills, 
which  readily  prepared  it  for  infusion.  The  ingenuity 
of  the  soldiers  furnished  means  often  original,  and  not 
always  prosaic,  for  preparing  it.  I  have  seen  in  our 
camps,  the  coffee  ground  by  a  ball  rolled  about  in  the 
half  of  a  bomb  shell.  The  English  replaced  coffee  by  tea, 
which  their  troops  took  morning  and  evening,  sea- 
soned with  rum.  Pieces  of  bread  soaked  in  this  grog 
afforded  a  nourishing  and  agreeable  food.  Thus  We  meet 
in  the  bivouac  with  the  home  usages  of  British  families. 


THE   CRIMEAN   WAR. 


39 


The  following  table  shows  the  rations  of  an  English 
soldier  in  the  Crimea  and  upon  the  Bosphorus  : — 


Bread, 
or  biscuit, 
Fresh  meat, 
or  salt  meat, 
Sugar, 
Rice, 
Coflee, 


IN  THE  CRIMEA. 


14-  pou 
l"       ' 

I4       ' 
2     our 
2 
1 

nds. 
ces. 

or  cocoa, 
or  tea, 
Wood, 
or  mineral  coal, 
or  charcoal, 
Candles,  per  man, 

1 

M 

2 

ounce. 


pounds. 


ON  THE  BOSPHORUS. 


Bread, 

or  biscuit, 

Fresh  or  salt  meat, 

Sugar, 

Coflee, 


1£  pounds. 
1         " 

1  " 

2  ounces. 
1 


Mixed  vegetables,         4  ounces, 

or  potatoes,                   8  " 

Rum,                              £  gill. 

Candles,  per  doz.  men,  3  ounces. 


On  days  when  they  issue  salt  meats,  they  give  besides, 
two-thirds  of  a  pint  of  peas  or  kidney  beans,  or  a  quar- 
ter of  a  pound  of  mixed  vegetables,  or  half  a  pound  of 
potatoes. 

As  an  antiscorbutic,  they  give  thrice  a  week  to  the 
troops,  some  lemon  juice,  and  four  pounds  of  sugar  to 
every  hundred  men. 

The  French  soldier  was  never  for  a  day  without 
food,  the  distributions  were  made  as  regularly  as  in  a  city 
garrison,  and  with  as  great  variety  as  was  possible  in  a 
country  without  resources,  and  eight  hundred  leagues 
from  France,  from  whence  everything  had  to  be  sent. 

I  will  here  offer  some  brief  observations  upon  the 
improvements  which  appear  to  me  practicable  to  intro- 
duce in  the  regimen  of  the  soldier.  Without  exceeding 
the  strict'  limits  of -expense,  I  believe  that  the  number 
of  sick  may  be  diminished,  and  along  with  this  the 
expense  of  hospitals,  by  giving  a  third  meal,  by  varying 
the  food,  and  by  increasing  its  amount.  Our  soldiers 
take  two  meals  :  one  at  ten  o'clock  in  the  morning,  and 
the  other  at  four  in  the  afternoon.  The  breakfast  is 
eighteen  hours  after  supper;  Now  a  man  may,  if  occu- 
pied with  intellectual  labor,  take  food  perhaps  only  twice 


40  THE   CRIMEAN   WAK. 

a  day  ;  but  the  young  soldier,  who  has  not  yet  reached 
his  full  growth,  and  who  is  exposed  to  a  great  expendi- 
ture of  physical  strength,  ought  to  eat  oftener.  Be- 
fore entering  the  service,  he  was  a  peasant  or  a  me- 
chanic, and,  practising  the  popular  adage,  "  never  go  to 
work  hungry,"  ate  before  beginning  his  labors.  When 
he  joined  the  regiment,  this  morning  repast,  which  lie 
had  taken  from  infancy,  and  which  to  him  is  a  real  want, 
is  at  once,  and  without  gradation,  cut  oif.  The  old  sol- 
dier, whose  stomach  is  less  imperious,  takes  good  care  to 
eat  a  piece  of  bread  and  drink  a  little  glass  of  brandy 
before  going  to  his  drill.  The  conscript  may  do  so 
likewise ;  but  always  in  a  hurry,  and  compelled  to 
regulate  his  life  by  the  tap  of  the  drum,  will  he  always 
find  time  to  take  this  irregular  repast  ?  If  it  is  useful, 
why  is  it  not  made  regular,  and  a  time  given  to  it  in 
the  distribution  of  the  daily  duties,  as,  for  example, 
at  seven  in  the  morning  ?  A  sup  of  coffee,  a  piece  of 
cheese,  an  onion,  a  little  bread  and  butter,  and  some 
wine,  would  be  sufficient. 

When  a  man's  food  is  not  varied,  his  health  quickly 
fails,  as  Magendie  has  demonstrated.  The  mariners 
who  in  a  long  voyage  are  reduced  to  biscuit  and  salted 
meat,  readily  contract  scurvy,  typhoid  fever,  and  some- 
times typhus.  The  soldier  eats  invariably  twice  a  day 
soup,  made  of  boiled  beef,  and  vegetables,  whose  quantity 
varies  with  the  price.  To  break  this  monotony,  the  men 
often  sell  their  bread  to  buy  fruits,  or  cheese ;  the  ration 
of  bread  is,  however,  estimated  from  the  wants  of  the 
system,  and  the  sale  of  a  part  weakens  the  body,  and 
procures  a  variety,  without  adequate  nourishment. 
These  two  eternal  soups  are  the  strongest  reasons,  and 
I  know  this  positively,  why  the  soldier  will  not  willingly 
re-enlist. 

In  1847,  a  scarcity  of  provisions  doubled  the  number 
of  the  sick;  a  fifth  part  of  the  effective  regimental 
forces  were  in  the  hospitals  and  infirmaries,  ninety-two 
scorbutic  patients  were  entered  at  Val-de-Grace,  and 
although  the  furloughs  of  convalescence  were  immensely 
numerous,  the  number  of  deaths  per  one  thousand  arose 
from  fourteen  to  twenty-nine.  During  the  same  year, 


THE    CRIMEAN   WAR.  41 

the  crack  regiment,  the  municipal  guards,  and  the  fire- 
men, who  were  able  on  account  of  their  supplementary 
pay  to  add  to  their  rations,  escaped  the  diseases  which 
raged  among  the  troops  of  the  line,  which  depended  upon 
their  simple  pay.  Thus  in  1855,  the  scurvy  attacked  the 
troops  at  Saint  Omer  in  so  serious  a  way,  as  to  call  for 
the  presence  of  M.  Maillot,  a  medical  inspector ;  nor  did 
it  yield,  until  certain  objectionable  features  in  the  pro 
visioning  were  reformed.  We  uniformly  observed,  in 
Algeria  as  in  France,  that  the  troops  employed  in 
manual  labor  in  the  open  air,  in  grading  or  stoning  the 
roads,  are  in  better  condition,  aside  from  the  marked 
and  conceded  influence  of  physical  labor  upon  the 
health;  and  this  fact  is  explained  by  the  extra  pay 
which  the  soldier  receives  for  these  labors,  and  which  in 
part  goes  to  increase  his  food. 

It  is  commonly  said,  that  the  soldier  is  better  fed  in 
the  army  than  in  his  family,  but  this  is  not  so  true  as  is 
generally  believed.  Besides,  ought  not  the  amount  of 
food  to  correspond  with  the  sum  of  physical  forces 
expended  ?  The  English  laborers,  who  began  our  rail- 
roads, and  whose  unwearying  vigor  astonished  our 
workmen,  ate  two  pounds  of  meat  daily;  flesh  nourished 
flesh.  The  French  soldier  receives,  bone  deducted,  at 
most,  one  hundred  and  twenty  grammes  (a  quarter 
of  a  pound)  of  meat  in  a  day.  I  admit  that  he  would 
eat  less  at  home,  especially  if  he  came  from  a  poor 
district,  but  at  least  he  would  have  an  abundance  of 
bread,  cabbage,  beans,  lard,  and  onions.  Butter  would 
vary  his  food  ;  and  milk,  cider,  or  at  least  weak  wine,  are 
worth  more  than  the  water  which  he  would  drink  in 
the  army.  His  labor  is  free,  and  without  disciplinary 
restraint,  and  he  has  no  forced  marches  to  make,  carry- 
ing an  equipment,  which  in  a  campaign  weighs  at  least 
fifty-five  pounds.  He  rests  when  he  is  weary,  eats  when 
he  is  hungry,  and  at  night,  instead  of  standing  sentry, 
he  sleeps  a  sleep  that  is  sound,  and  breathes  full  volumes 
of  fresh  air,  and  not  such  air  as  is  rationed  out  in  the 
rooms  of  a  barrack.  The  greater  number  of  diseases, 
and  especially  of  tubercular  phthisis  and  typhoid  fever, 
so  common  in  the  army,  have  no  other  cause  than  a 

3* 


42  THE   CRIMEAN   WAR. 

vitiated  air.  In  Algeria,  the  regiments  which  labored 
on  the  roads,  during  the  heats  of  summer,  in  the  open 
air,  never  had  these  diseases  ;  but  on  the  return  of  winter 
and  bad  weather,  when  they  were  driven  into  the 
barracks,  they  presently  paid  a  heavy  tribute  to  disease. 
The  expense  of  supply  for  a  company  of  eighty  men  is 
one  hundred  and  sixty  dollars  per  month,  which  is 
derived  as  follows:  one  hundred  and  fifty-six  dollars 
and  twenty-four  cents,  total  of  six  cents  and  five  mills 
per  day,  taken  from  the  wages  of  each  man ;  four 
dollars  at  least  per  month,  from  the  sale  of  grease 
and  slops,  besides  what  is  earned  by  the  soldiers  who 
labor  in  town,  and  that  which  is  paid  by  the  officers 
for  orderlies,  and  which  go  to  the  soldiers  in  common. 
The  company  consumes  daily  in  bread  for  soup,  one 
dollar  and  twenty-one  cents,  in  meat  three  dollars  and 
thirty-five  cents,  in  vegetables  twenty-eight  cents,  in 
pepper  and  salt  nine  cents.  This  four  dollars  and 
ninety-three  cents  per  diem,  amounts  to  about  one 
hundred  and  forty-seven  dollars  and  ninety  cents  in  a 
month ;  and  allowing  nine  dollars  and  ninety-eight  cents 
for  washing,  lights,  and  blacking,  for  brooms,  and  the 
barber's  fee,  there  is  left  two  dollars  and  twelve  cents 
for  some  contingent  expenses.  Many  commanding 
captains  have  a  foolish  tendency  towards  economising 
in  the  mess  expenses,  which  results  finally  in  large 
mortality.  I  have  been  astonished  to  see  them  intrust 
to  a  corporal  the  duty  of  buying  provisions ;  as  corpo- 
rals are  rarely  ^insensible  to  the  seductions  of  a  glass  of 
brandy;  the  merchants,  who  know  their  weakness  on 
this  point,  turn  it  to  their  advantage,  to  the  detriment 
of  the  company.  It  would  be  better  that  a  special  com- 
mission should  have  charge  of  the  sustenance  of  the 
regiment.  They  could  then  deal  directly  with  the 
producers,  and  by  dispensing  with  intermediaries,  bene- 
fit the  regiment  to  the  whole  extent  of  the  profits  made 
by  second  and  .third  hands.  Bought  upon  hoof,  the 
meat  would  be  cheaper,  and  perhaps  of  better  quality, 
the  soldiers  might  cut  it  up  themselves,  and  thus  initiate 
themselves  into  camp  life.  It  may  be  objected,  that  the 
soldier  is  suspicious,  and  ought  to  be  left  to  dispose  of 


THE    CKIMEAN    WAK.  43 

the  funds  destined  for  his  nourishment  according  to  his 
own  fancy  ;  but  the  commission  might  embrace  a  repre- 
sentative from  each  company.  Besides,  the  State,  in 
supplying  the  funds,  reserves  to  the  fullest  extent  the 
right  of  control,  and  its  interests  are  identical  with 
those  of  the  soldier. 


CHAPTER    III. 

CAMPS    AND   SHELTERS. 

THE  three  camps  of  the  French  army  were  located 
upon  elevated  grounds,  with  good  hygienic  conditions. 
The  air  circulated  freely,  and  purified  them  constantly. 
The  inclosure  was,  however,  too  scanty,  the  tents  almost 
touching  one  another.  There  should  have  been  left  suf- 
ficient space  to  allow  of  their  being  moved  occasionally, 
to  purify  the  ground  as  it  became  infected  by  use.  As 
for  the  barracks,  the  evil  was  without  remedy.  It  is 
a  fatal  custom  thus  to  huddle  together  the  tents  and 
barracks.  In  the  Crimea,  safety  made  this  necessary; 
but  at  Constantinople,  far  from  the  seat  of  war,  the 
camps,  barracks,  and  the  hospitals  were  altogether  too 
close ;  and  to  the  noxious  exhalations  thus  engendered 
were  to  be  attributed  the  persistence  of  cholera  and  the 
ravages  of  hospital  gangrene  and  typhus.  To  the  phy- 
sician who  asks  for  more  space,  it  is  replied  that,  it  is  of 
the  first  importance  to  economise  the  labor  of  the 
service,  and  so,  to  save  a  few  steps,  they  violated  some 
of  the  most  simple,  yet  most  important  laws  for  the 
preservation  of  health. 

The  physicians  also  found  that  the  location  of  the 
camps,  even  when  nothing  controlled  the  liberty  of 
choice,  was.  not  always  well  selected.  At  Constantino- 
ple, a  barrack  camp  was  laid  out  scarcely  half  a  mile 
from  a  miry  plain,  but  the  invasion  of  intermittent  fever 
caused  it  to  be  abandoned.  It  is  further  to  be  observed, 
that  two  camps,  or  two  barracks,  or  two  hospitals,  were 


44  THE   CRIMEAN  AVAR. 

never  made  upon  the  same  model ;  and  often  a  real  per- 
fection in  arrangement  was  superseded  by  an  injudicious 
innovation.  It  would,  however,  be  sensible  enough  to 
prescribe  a  plan  drawn  up  by  a  commission  composed  of 
officers  of  engineers  and  of  the  medical  staff. 

Camps,  when  stationary,  tend  rapidly  to  infection, 
but  they  cannot  always  be  changed ;  for  in  winter  the 
softened  soil  often  prevents  the  work  of  removal ;  and, 
besides,  camps  often  occupy  military  positions  which 
may  not  be  abandoned.  We  must  submit  to  these 
necessities,  with  the  determination  of  withdrawing  at 
the  first  opportunity.  The  signing  of  the  peace  allowed 
us  to  remove  our  camps  along  the  valley  of  the  Tcher- 
naia,  upon  new  and  elevated  ground,  exposed  to  the  sea 
breeze.  The  officers  were  loth  to  quit  the  conveniences 
they  had  arranged ;  but  Marshal  Pelissier  commanded, 
and  they  obeyed. 

When  a  camp  ground  cannot  be  changed,  it  is  neces- 
sary to  double  our  vigilance,  in  '  order  to  expel  the 
organic  miasms  and  purify  the  air,  by  sprinkling  the  soil 
in  the  tents  with  lime  water,  by  placing  a  dish  of  hypo- 
chlorate  of  soda  in  a  corner,  by  taking  down  the  tent 
when  the  weather  allows,  or  at  least  tying  up  the  sides 
80  centimetres  (32  inches)  from  the  ground  during  the 
most  of  the  day.  Soldiers  take  so  little  care  of  their 
health  that  they  must  be  made  to  come  out  of  their  tents, 
or  they  will  remain  squat  within,  even  in  fine  weather ; 
and  should  be  compelled  to  dry  their  clothes  and  blan- 
kets in  the  sun.  The  cavalry  were  more  attentive  than' 
the  foot  soldiers  (Zouaves  excepted),  to  these  simple 
requirements,  which  were  issued  as  army  orders.  But 
the  infantry  gave  them  the  most  faithful  trial. 

The  cemeteries  were  placed  far  enough  from  the 
camps  to  be  free  from  noxious  exhalations,  and  all  the 
recommendations  of  the  Army  Council  of  Health  were 
always  regularly  observed  concerning  them.  Large 
quantities  of  quicklime  and  of  chloride  of  lime,  of  which 
;we  had  an  abundance,  were  used  in  them  and  in  the 
slaughter  yards.  It  was  said,  and  published,  that  the 
dead  carcasses  of  animals  poisoned  the  air  of  our  camps ; 
but  this  was  untrue,  as  they  were  immediately  buried. 


THE   CRIMEAN   WAK.  45 

General  Canrobert,  at  the  beginning,  encouraged  their 
burial,  and  this  was  regularly  done. 

The  habits  of  cleanliness  which  distinguished  the  Eng- 
lish army,  should  have  been  followed  in  our  camps.  They 
washed  their  body  linen  in  warm  water,  and  changed 
twice  a  week,  but  our  soldiers  were  not  so  careful. 
Filthiness  checks  the  functions  of  the  skin,  and  engen- 
ders vermin.  When  a  patient  arrived  at  Constantino- 
ple, we  first  washed  his  garments  in  boiling  water.  On 
a  review  day,  our  soldiers  presented,  by  their  new  and 
well-brushed  uniforms,  an  irreproachable  military  aspect ; 
but  these  fine  battalions  left,  as  they  passed,  the  marked 
and  well-known  stench  of  the  barracks.  Is  neatness 
inconlpatible  with  the  soldier's  profession  ?  The  Turk 
finds  time,  in  the  midst  of  a  campaign,  to  perform  many 
times  in  a  clay  the  ablutions  required  by  his  religion ; 
and  surely  military  discipline  ought  to  be  as  imperative 
as  the  law  of  Mahomet !  If  that  has  achieved  so  meri- 
torious a  victory,  military  education  should  introduce 
gradually  into  the  families  of  our  laborers  and  peasants, 
those  cleanly  habits  which  we  so  envy  in  the  English. 
This  would  be  a  national  reform,  which  would  result  in 
profit  to  the  public  health.  Our  quarters  for  troops  shine 
with  the  greasy  filth  of  daily  neglect.  It  is  forbidden — 
would  any  one  believe  it? — to  scrub  the  floors,  the 
benches,  and  the  tables,  for  fear  of  wearing  them  out. 
Why  cannot  a  barrack  be  kept  as  neatly  as  a  ship,  and 
why  cannot  floors,  waxed  and  rubbed  by  the  soldiers, 
take  the  place  of  the  imperfect  tiling  in  the  rooms?  We 
have  introduced,  at  length,  this  luxury  into  our  military 
hospitals,  in  spite  of  the  opposition  of  routine ;  and',  upon 
entering  the  barracks,  may  ask  with  surprise,  why  such 
useful  reforms  are  so  slow  in  finding  their  place  here? 

The  shelters  of  the  army  of  the  East  were  of  different 
kinds,  and  for  want  of  houses  it  adopted  more  primitive 
habitations.  In  the  Crimea,  we  had  huts,  shelter-tents,* 

*  The  tente-abris  is  a  slight  shelter,  sufficient  to  cover  a  soldier  in 
the  bivouac,  and  so  light  that  it  can  be  packed  up  like  a  knapsack, 
and  carried  on  the  march.  Its  construction  and  use  are  described  on 
a  subsequent  page.  They  are  about  being  introduced  into  the  Ameri- 
can army.— Tn. 


46  THE   CRIMEAN   WAR. 

and  conical  tents.  The  huts,  which  our  soldiers  called 
mole-hills,  were  dug  a  yard,  at  least,  below  the  surface, 
and  were  about  seven  yards  long  by  three  wide  and 
two  and  a  half  high.  The  floor  and  sides  were  covered 
with  stone  when  they  could  be  had.  The  walls  were 
raised  above  the  surface  by  brush  woven  together,  and 
covered  with  a  thick  coat  of  clayey  earth,  and  upon 
these  was  placed  a  roof,  with  double  slope,  made  of  the 
same  materials.  One  or  two  openings  in  the  roof  admit- 
ted light,  but  these  were  closed  with  a  sod  when  it 
rained.  Whenever  fuel  was  wanting,  these  huts  were 
always  dangerous  to  health,  and  the  Piedmontese  regi- 
ment, who  lived  in  huts  without  chimneys  or  fire,  had 
many  sick.*  On  the  other  hand,  the  division  cantoned  in 
the  forest  of  Baidar  could  have  had  no  better  habitation, 


*  The  pernicious  habit  of  sinking  the  floors  of  tents  below  the 
surface  of  the  ground  has  almost  always  been  punished  by  increased 
sickness  and  mortality.  Upon  many  occasions,  while  inspecting  the 
camps  in  winter  quarters,  in  the  army  of  the  Potomac,  in  the  winter 
of  1861-2,  the  writer  has  observed  that  the  sickly  companies  and 
squads  were  those  that  lived  in  tents  with  excavated  floors.  This 
disregard  of  health  should  be  charged  to  the  officers  permitting  it. 
The  sides  and  floor  of  such  a  tent  can  never  be  dry,  or  the  ventilation 
perfect,  unless,  perhaps,  in  cases  where  an  open  wood  fire  with  a  good 
draught  is  maintained.  Carbonic  acid  gas  will  settle  into  the  bottom  of 
the  tents,  where  the  men  lie,  and  typhoid  fevers,  rheumatism,  and 
catarrh  will  swell  the  numbers  attending  the  sick  call  and  filling  the 
hospitals.  The  practice  prevents  the  frequent  removal  of  tents  to  new 
grounds,  and  renders  cleanliness  impossible.  The  floor  of  a  tent,  some- 
what raised  above  the  natural  surface,  well  drained,  and  previously 
dried  by  the  burning  of  brush,  presents  the  opposite  conditions  for  the 
maintenance  of  health. 

The  army  of  the  Potomac,  in  the  winter  quarters  of  1861-2,  were 
well  supplied  with  wood,  and  very  few  tents  were  without  fires.  The 
fixtures  for  warming  varied  infinitely,  and  embraced  a  great  variety 
of  open  fire-places,  of  brick,  stone,  mud,  or  sods,  with  chimnej's  of  the 
same,  with  or  without  an  additional  draught  made  of  boards,  barrels, 
sticks  and  mud,  or  hollow  logs;  sheet-iron  stoves,  with  or  without 
pipes;  open  fires  in  the  middle  of  large  tents,  with  ventilation  at  the 
top;  or,  what  was  still  more  objectionable,  kettles  of  embers  from  the 
kitchen  fires.  Of  these,  the  open  fire-place,  with  a  chimney,  was  the 
only  kind  without  its  faults;  and  the  chief  difficulty  in  its  use,  arose 
from  the  increased  quantity  of  wood  required.  ,  The  thousands  of  acres 
of  oak  timber,  cut  down  as  a  military  necessity,  allowed  no  limit  to  be 
placed  upon  this  luxury,  except  that  of  transportation. — Tn. 


THE    CRIMEAN   WAK.  47 

for  being  well  supplied  with  wood,  they  kept  tip  fires  day 
and  night.  Nothing  is  so  cheering  as  a  large  fire  in  a 
bivouac,  and  wood  is  half  the  life  of  a  campaign.  While 
warming  himself  in  the  open  air,  the  soldier  escapes  the 
emanations  of  the  common  quarters ;  and  when  the  fire  is 
carried  into  the  huts,  it  renews  the  air  with  great  advan- 
tage. A  day  of  reckoning  with  rheumatism  may  hereaf- 
ter come ;  but  in  war  we  cannot  always  be  so  prudent. 

I  visited  a  Russian  camp,  where  the  troops  live  in 
huts  similar  to  ours,  but  larger,  wider,  and  deeper,  with 
sheets  of  oiled  paper  instead  of  glass.  Wood  had  become 
scarce,  and  the  air,  not  cleansed  by  the  fire,  was  heavy, 
damp,  nauseating,  and  scurvy  and  typhus  abounded. 

To  Marshal  Bugeaud,  we  owe  the  ingenious  contri- 
vance of  the  Shelter  Tent,  made  from  the  camp  sack  of 
the  soldier.  Its  seams  are  replaced  by  rows  of  buttons, 
so  that  it  can  be  changed  at  will  into  a  square  piece  of 
cloth ;  and  when  two  of  these  are  buttoned  together, 
and  drawn  over  a  pole,  raised  about  a  yard  from  the 
ground,  and  the  corners  fastened  by  pegs,  the  two  owners 
of  the  sacks  are  sheltered  under  the  tent.  Thus  was 
resolved  the  great  question,  as  to  how  we  might  escape 
the  double  inconvenience  of  overloading  the  shoulders 
of  our  troops,  and  of  transporting  tents  in  the  train  of 
an  army,  by  expensive  and  often  impracticable  means. 
Ouivtroops  become  movable  and  nomadic,  like  the  Arabs 
whom  they  pursue.  This  tent  did  us  great  service  in  the 
Crimea,  but  was  of  little  service  during  the  rigors  of 
winter;  for  when  placed  on  the  ground  it  was  too  cold, 
and  when  covered  with  a  bed  of  snow  it  was  too  warm, 
and  the  air  within  was  rapidly  tainted. 

The  conical  tent  is  made  for  sixteen  men.  A  single 
pole  in  the  centre  supports  the  top,  while  around,  it  is 
very  firmly  fastened  to  the  ground  by  two  sets  of  ropes, 
one  of  which  is  fixed,  and  the  other  movable,  allowing 
the  walls  to  be  raised  some  two  feet  to  ventilate  the 
interior.*  They  resisted  bravely  the  force  of  the  winds, 

*  The  Crimean  tent  has  been  furnished  to  a  few  of  the  regiments 
in  the  American  army,  but  not  so  extensively  as  the  Sibley  tent,  which 
is  taller,  and  descends  to  the  ground  at  a  wider  angle,  covers  less 
ground,  and  has  a  large  opening  for  ventilation.  The  latter,  resem- 


48  THE    CRIMEAN    WAE. 

and  the  Turks  prefer  them  to  all  others.  They  make 
them  of  a  very  close  woven  texture,  and  the  Sultan 
furnished  a  large  number  of  very  superior  quality.  Ours 
were  made  of  cloth  of  open  texture,  which  allowed  the 
rain  to  sift  through ;  but  although  not  so  warm,  they 
were  more  healthy  in  summer,  because  they  allowed  the 
air  to  circulate,  while  in  winter  their  fault  was  reme- 
died by  placmg  one  over  another. 

Marquees  are  a  more  complicated  affair  than  the 
conical  tents,  and  as  they  do  not  well  resist  the  wind 
they  were  not  used  for  sheltering  troops  in  the  Crimea. 
Still  they  are  more  healthy  and  agreeable  abodes ;  their 
vertical  walls  inclose  a  much  larger  volume  of  air,  they 
are  very  easily  ventilated,  and  are  as  roomy  as  a  common 
chamber.  On  these  accounts,  they  were  used  for  the 
sick.*  The  English  constructed  during  the  summer,  for 
their  regimental  infirmaries,  marquees  of -large  size,  each 
holding  twenty-four  iron  bedsteads,  and  as  many  bedside 
tables.  The  planks  were  movable,  and  kept  with  great 
neatness ;  and  every  patient  had  a  mat  by  his  bedside, 
and  a  hospital  robe.  An  army  on  the  march  could  not 
unfortunately  enjoy  a  convenience  so  cumbersome ;  as  to 
move  one  of  these  tents,  with  its  furniture,  would  re- 
quire at  least  twenty-five  mules!  In  winter  they  were 
replaced  by  barracks.  The  Russians  also  employed 
tents  of  very  large  size  for  their  sick,  and  I  saw  several 
erected  near  the  hospital  at  Balbec ;  they  served,  so 

bling  in  outline  a  Sioux  lodge,  from  which  it  was  perhaps  modelled, 
was  first  supplied  to  our  troops  in  the  expedition  to  Utah,  and  pos- 
sesses advantages  over  many  if  not  over  all  other  kinds  now  used.  It 
is  often  stockaded  to  a  height  of  three  or  four  feet  from  the  ground, 
thus  affording  additional  accommodation.  Around  the  central  pole 
is  placed  the  rack  for  arms,  and  a  conical  sheet  iron  stove  with  pipe 
passing  through  the  ventilator,  enables  the  inmates  to  keep  their 
quarters  comfortably  warm  in  winter.  In  a  cavalry  camp,  they  may 
afford  shelter  to  the  saddles,  an  economical  measure  impossible  in  the 
common  wedge  tents. — TR, 

*  The  Marquee,  or  wall  tent,  covered  with  a  fly  or  stretch  of  can- 
vas, supported  at  the  ridge  by  the  same  pole,  but  descending  at  a  less 
angle,  so  as  to  allow  of  the  free  circulation  of  air  between  the  two, 
is  the  variety  furnished  to  officers  in  the  American  army.  When  two 
of  these  are  united,  they  present  an  outer  and  an  inner  appartment. 
and  very  satisfactory  accommodations. — TR. 


THE   CRIMEAN   WAR.  49 

I  was  told,  to  isolate  the  soldiers  tainted  with  severe 
and  infectious  diseases. 

The  choice  of  ground  for  a  tent  is  of  great  impor- 
tance. It  should  be  exposed  to  the  air,  and  free  from 
dampness,  should  be  upon  elevated  but  not  exposed 
places,  and  should  have  ditches  for  carrying  off  the  rains. 
If,  in  winter,  to  keep  out  the  cold,  the  tent  is  surrounded 
by  a  wall  of  dry  stone,  it  should  be  taken  down  as  soon 
as  fine  weather  sets  in.  It  is  a  great  fault  to  bury  tents 
to  a  certain  depth  to  make  them  warm,  for  they  are 
then  damp,  and  more  difficult  to  cleanse.  In  the  Crimea, 
some  of  the  tents  had  their  floors  muddy  through  the 
whole  winter. 

For  a  bed,  every  soldier  should,  under  the  regulations, 
receive  a  bundle  of  straw  every  fifteen  days ;  but  in  a 
campaign  this  can  seldom  be  furnished.  It  might  be 
better  to  provide  every  man  with  a  piece  of  water- 
proof cloth,  which  he  could  use  as  a  shawl  when  it 
rained,  and  as  a  screen  from  the  dampness  of  the  ground 
in  the  bivouac  at  night.  The  sheepskin,  which  was 
given  instead  of  the  bundle  of  straw,  became  loaded 
with  humidity,  and  propagated  vermin.  The  field  hos- 
pitals and  regimental  infirmaries  had  movable  plank 
floors,  and  a  kind  of  mat  beds.  After  the  taking  of 
Sebastopol,  some  of  the  colonels  covered  the  ground  of 
the  tents  with  wood  brought  from  the  city,  or  with 
a  thin  layer  of  nut  tree  branches,  of  which  quantities 
were  found  in  the  forest. 

The  camp  of  the  81st  regiment  was  a  genuine  model 
of  arrangement.  Its  spacious  tents  were  carefully  in 
line,  upon  broad  paved  streets  bordered  with  fir  trees, 
which  the  regiment  had  planted.  They  were  opened 
during  the  day,  and  contained  a  folding  bed,  which  was 
turned  up  when  not  in  use,  and  replaced  when  the 
hour  for  retiring  came.  The  utmost  neatness  was  pre- 
served. Nothing  was  wanting.  Even  scrapers  for  the 
feet,  made  from  broken  sabres,  were  provided  at  the 
thresholds.  In  their  infirmary,  the  regiment  had,  from 
its  own  resources,  provided  fifty  beds;  well  arranged 
ventilators  renovated  the  air,  and  an  excellent  fireplace 
kept  the  temperature  at  from  14°  to  16°  Centigrade 


50  THE  CEIMEAN   WAK. 

(58°  "to  60°  Fahrenheit).  Upon  a  visit,  unannounced,  I 
found  the  colonel,  M.  de  Clonard,  presiding  at  a  distri- 
bution of  oranges  purchased  for  the  scurvy  patients ; 
under  a  shed,  I  counted  thirty  or  forty  barrels  of  wine, 
kept  in  reserve  for  days  of  great  fatigue.  Fields  of 
barley,  wheat,  and  potatoes  had  been  sowed  for  the 
common  supply,  and  they  had  even  constructed,  at  the 
camp,  a  plough  of  the  Dombasle  fashion!  The  regi- 
mental band  daily  discoursed  cheerful  airs  upon  a 
beautiful  esplanade,  planted  with  trees  by  the  soldiers, 
and  adorned  with  a  fine  rustic  cafe.  Beyond  the  color- 
line  there  was  a  row  of  little  stone  buildings ;  the 
boxes  that  had  contained  the  preserved  vegetables  fur- 
nished materials  for  the  roofs,  and  even  for  stovepipes. 
These  were  the  kitchens  of  the  several  companies. 
M.  de  Clonard  had  thus  turned  to  account  the  thousand 
pair  of  hands  of  his  regiment,  when  war  gave  them  no 
further  employment ;  had  banished  homesickness  and 
diseases,  introduced  gaiety  and  health,  and  preserved 
his  effective  strength  almost  entirely  unimpaired. 

The  English  army  passed  the  whole  of  the  winter  of 
1856  in  well  closed  barracks.  Every  morning,  the 
boards  upon  which  the  soldiers  lay,  were  sprinkled,  with 
fine  sand,  which  was  swept  off  at  night ;  stoves  of  mine- 
ral coal  were  kept  continually  burning,  which  allowed  of 
the  ventilators  being  always  open.  Two  temporary 
barracks  served  as  reading-rooms,  where  there  were 
books,  benches,  a  table,  pens,  ink,  and  paper.  The 
English  soldiers  burned  the  offal  of  their  camps,  while 
the  French  buried  it.  In  winter,  the  heap  of  offal 
burned  with  difficulty,  and  with  a  black,  stinking  smoke 
that  spreads  through  the  whole  cantonment.* 

The  materials  for  building,  taken  from  the  ruins  of 
Sebastopol,  having  been  divided  equally  between  the 
English  and  the  French,  were  then  apportioned  to  the 
regiments.  Without  these,  the  army  would  have  suf- 
fered cruelly  during  the  winter  of  1856.  It  was  worth 

*  The  English  reports  show  that  their  manure  heaps  were  swept 
up,  and,  on  the  whole,  well  burned.  The  most  approved  manner  of 
burning  was  in  kilns,  made  somewhat  after  the  fashion  of  lime 
kilns. — TR. 


THE   CRIMEAN   AVAR.  51 

noticing  the  zeal  with  which  the  soldiers  sought  wood 
under  the  rubbish,  and  loaded  it  upon  their  shoulders  or 
upon  .their  arabas.  Planks,  beams,  windows,  broken 
doors,  bricks,  tiles,  and,  in  short,  everything  was  taken 
that  could  be  turned  to  use.  The  Russians,  seeing 
them  so  busy,  sought  to  annoy  them  with  cannon, 
but  our  soldiers  allowed  no. such  little  affair  to  disturb 
them.  I  have  seen  them  climb  upon  the  roofs  of  the 
highest  buildings,  to  strip  off  the  sheets  of  zinc.  The 
Russians  would  shoot  at  them  as  at  a  target,  and  they 
would  reply  by  a  mocking  gesture  well  known  among 
the  blackguards  of  Paris. 


CHAPTER   IV. 
CLOTHING. 

As,  in  the  Algerine  war,  we  introduced  into  our  military 
costume,  modifications  appropriate  to  the  climate,  so,  in 
the  Crimean  war,  we  borrowed  from  the  native  Tartars 
certain  garments  which  better  shielded  our  soldiers 
against  the  rigors  of  their  winter. 

The  Crimeenne  is  a  long  and  ample  hooded  cloak, 
with  a  little  cape,  and  falls  to  the  middle  of  the  leg. 
The  cloth  is  coarse,  but  warm,  and  almost .  water-proof. 
Excepting  the  general  officers,  who  wore  an  overcoat 
trimmed  with  fur,  everybody  wore  the  Crimeenne,  and 
it  replaced  the  African  burnous,  and  the  Caban.  It 
proved  very  useful,  and  will  perhaps  l^e  regularly 
adopted,  as  it  guards  the  soldier  from  diseases  acquired 
so  often  by  passing  suddenly  from  the  high  tempera- 
ture of  the  guard-room  to  the  cold  outside  air,  in 
mounting  guard  at  night.  The  hood  shields  the  head 
and  neck  from  the  cold,  the  wind,  and  dampness ;  pre- 
vents the  engorgement  of  the  glands  of  the  neck,  and 
the  bronchitis,  to  which  they  are  liable  from  the  chill. 
A  preparation  of  India-rubber  would  easily  render  the 
little  cape  which  covers  the  shoulders  water-proof. 
This  garment  would  replace  with  advantage  the  blan- 


52  THE   (TRIMEAN   WAR. 

ket,  which  the  soldier  carries  upon  his  knapsack,  and 
which  gives  him  so  ridiculous  an  appearance. .  The 
blanket,  so  awkwardly  perched  upon  the  knapsack, 
when  wet,  is  very  heavy,  and  dries  with  difficulty. 
When  dry,  it  weighs  about  three  pounds  and  a  half. 
Therefore  in  summer,  in  order  not  to  load  the  shoulders 
of  the  men  too  much,  they  give  them  only  a  half  blan- 
ket, the  other  half  being  kept  for  the  approach  of  win- 
ter. The  storage  of  these  half  blankets  is  not  easy,  and 
the  army  runs  the  risk  of  being  deprived  of  them  if 
their  supplies  cannot  follow  them.  But  the  crimeenne 
has  none  of  these  inconveniences,  is  not  so  heavy,  and 
can  be  made  still  lighter,  and  the  knapsack  is  relieved 
from  the  difference  in  weight. 

French  taste,  which  sometimes  blunders,  has  often 
attempted  to  rob  this  garment  of  its  essential  qualities. 
To  render  it  more  elegant,  the  officers  have  worn  it 
shorter,  narrower,  and  without  the  cape  or  hood, 
but  it  was  no  longer  the  crimeenne,  and  had  lost  its 
peculiar  advantages.  The  only  change  which  appears 
practicable,  would  be  to  place  a  flap  behind,  as  in  the 
old  infantry  cloak,  with  the  view  of  giving  them  at  will 
more  or  less  breadth,  without  drawing  in  those  great 
flowing  folds,  which  draped  so  nobly  our  brave  sol- 
diers, and  gave  them  so  majestic  an  appearance.  The 
crimeenne,  with  the  tunic,  would  form  the  winter  dress. 
The  tunic  appears  to  me  scanty,  and  should  be  made 
more  pretentious.  A  loose  uniform  is  at  the  same  time 
more  healthy  and  more  military ;  the  costume  of  the 
Zouave  is  an  example. 

The  Russian  officers  and  soldiers  wore  a  grey  habit, 
very  coarse,  but  warm,  and  shedding  the  rain  very  well. 
It  descended  almost  to  the  feet;  strings  to  allow  of 
its  being  drawn  in  at  will  gather  the 'folds  upon  the 
back,  and  this  gathering  does  not  give  them  a  very 
graceful  appearance.  I  would  much  prefer  the  flap 
which  we  had,  and  which  the  Austrians  still  use.  The 
habit  of  the  officers,  and  even  of  the  generals,  is  like 
that  of  the  privates,  except  a  little  lace  upon  the 
shoulder.  The  lace  of  the  generals  is  ornamented 
with  two  or  three  stars,  according  to  the  rank. 


THE   CRIMEAN   WAR.  53 

The  English  have  not  adopted  the  crimeenne,  but 
have  borrowed  from  us  the  tunic,  and  have  adopted  as 
an  overall,  a  long  spencer,  of  brown  knit  stuff,  protect- 
ing effectually  the  chest  and  lumbar  region,  while  it 
leaves  a  perfect  freedom  of  movement ;  but  this  does 
not  compensate  for  the  qualities  of  the  crimeenne.  Our 
allies  have  supplied  its  place  with  several  distinct  gar- 
ments. In  place  of  the  hood,  they  adopted  a  kind  of  otter- 
skin  helmet,  falling  over  the  ears  and  cheeks,  and  leaving 
none  of  the  face  in  sight  but  the  eyes  and  mouth ;  and 
the  cloak  was  replaced  by  a  large  piece  of  india-rubber 
cloth,  upon  which  they  lay  at  night  in  the  bivouac.  Our 
troops  also  wore,  at  the  beginning  of  the  war,  a  kind  of 
spencer,  with  sleeves  made  of  sheepskin,  the  wool  with- 
in, and  next  to  the  body.  This  costume  was  not 
graceful,  but  what  was  worse,  it  often  was  too  warm, 
and  caused  profuse  perspiration.  When  the  cold 
weather  was  over,  there  was  danger  in  leaving  it  off, 
as  the  body  had  been  accustomed  to  the  moisture. 
The  wool  retained  the  humidity,  and  the  grease  defiled 
the  outer  garment,  while  vermin  found  ample  shelter. 
It  was  entirely  given  up. 

A  girdle  of  flannel  is  the  best  preventive  against 
diarrhoea,  the  precursor  of  dysentery,  so  fatal  in 
armies;  and  the  old  soldiers,  accustomed  to  it  in  the 
African  war,  took  care  not  to  leave  it  off.  The  conscripts, 
who  knew  not  its  value,  lost  it,  or  left  it  in  their  knap- 
sacks, in  which  cases  the  blame  ought  to  rest  upon  the 
officers  and  physicians ;  as  the  measure  was  prescribed 
by  the  minister  of  war,  and  they  ought  to  see  it  carried 
into  effect. 

Each  English  soldier  had  two  flannel  shirts.  No- 
thing is  more  healthy  than  woollen,  for  in  winter  it 
gives  a  genial  warmth,  and  promotes  the  functions  of 
the  skin,  while  in  summer  it  prevents  the  arrest  of  per- 
spiration. The  Arabs  scarcely  wear  any  but  woollen 
garments,  and  our  marines  use  them  in  all  climates.  Two 
woollen  shirts  are  scarcely  heavier  than  a  common  soldier's 
shirt,  and  could  take  its  place  in  the  knapsack.  When 
wet  through,  the  soldier  by  putting  the  other  on  might 
escape  bronchitis,  which  is  so  common,  or  pneumonia, 


54  THE   CRIMEAN   WAE. 

which  proves  so  often  fatal.  While  I  await  the  adoption 
of  the  woollen  shirt  for  our  soldiers  in  the  field,  I  ask 
that  it  should  be  given  to  our  sick,  in  the  regular  and 
field  hospitals. 

The  whole  array  was  provided  with  long  gaiters 
made  of  coarse  warm  cloth,  and  reaching  to  the  knees, 
like  those  of  the  soldiers  under  the  Empire.  They  sup- 
ported the  leg  sufficiently  in  marching,  and  prevented 
varices.  The  greaves  of  leather  actually  used,  hardened 
by  wet  and  by  frost,  excoriated  the  ancles,  and  were 
too  cold  in  winter,  and  too  warm  in  summer.  On  the 
other  hand,  those  of  cloth,  besides  wearing  out  sooner, 
retained  the  wet  when  it  rained,  and  in  fact  acted  upon 
the  leg  like  a  sponge.  The  soldiers,  having  but  a  single 
pair,  could  not  always  be  dry.  They  also  had  greaves 
of  sheepskin,  the  wool  on  the  inside,  but  they  also 
retained  the  moisture,  and,  dried  before  a  fire,  became 
horny,  rigid,  and  brittle.  It  was  not  an  easy  thing  to 
recognise  the  soldier,  in  a  man  wearing  a  spencer,  sheep- 
skin greaves,  and  wooden  shoes.  But  this  outfit  was 
only  a  temporary  one,  and  was  soon  put  aside. 

Woollen  stockings,  although  excellent  when  dry  and 
clean,  often  remained  wet  when  the  soldier  was  depriv- 
ed of  fire  in  the  bivouac ;  and  many  a  man  has  had  his 
feet  frozen,  by  sleeping  with  wet  woollen  stockings  and 
shoes.  The  woollen  slippers  contained  in  the  wooden 
shoes,  were  always  dry ;  and  the  latter  were  often  neces- 
sary, even  in  very  cold  weather,  when  the  shoes,  long 
damp,  had  been  so  hardened  by  the  cold,  that  they 
could  not  be  put  on  until  they  had  been  softened  by 
warmth.  The  common  shoe,  covered  with  a  greave  of 
leather,  was  not  sufficient  in  a  country  without  roads 
and  thoroughly  sodden  with  wet.  After  the  sad  ex- 
perience of  the  winter  of  1855,  the  English  furnished  their 
troops  with  strong  boots  of  yellow  leather,  soft,  water- 
proof, and  reaching  to  the  knees,  such  as  those  used  by 
sportsmen.  They  were  an  aggravating  luxury,  and  half 
boots  were  even  preferable  upon  the  march. 

The  Russians,  who  understood  the  countrv,  had 
adopted  the  half-boot.  The  firmness  and  closeness  of 
their  leather  enabled  them  to  travel  in  underbrush 


THE   CRIMEAN   WAE.  55 

woods  without  tearing,  or  in.  the  water  without  soaking 
them.  The  leg  of  these  half-boots  was  large  enough 
to  admit  the  pantaloon  legs.  This  kind  of  shoes  ought 
to  be  adopted  for  our  soldiers,  two  pairs  being  furnished 
to  each  man ;  one  for  summer,  with  greaves  of  white 
cloth,  and  the  other,  a  half-boot,  for  winter.  Remem- 
bering with  what  eagerness  our  soldiers  despoiled  the 
Russian  dead  of  their  half-boots,  we  may  be  assured 
that  this  reform  would  be  popular  with  them ;  they  know 
what  is  good  for  themselves. 

In  times  of  peace,  the  knapsack  contains  articles  for 
the  toilet,  and  four  packages  of  cartridges  without  balls ; 
the  total  weight  is  fifteen  and  a  half  pounds.  If  we 
add  the  blanket,  shelter  tent,  little  wooden  bowl,  little 
tin  can,  cross-belt,  waistcoat,  cartridge  box,  sabre,  gun, 
and  bayonet,  and  two  days'  rations,  we  have  about  fifty- 
three  and  a  half  pounds  weight.  In  a  campaign,  this 
is  considerably  increased,  and  sometimes  amounts  to 
sixty-six  pounds,  at  the  time  of  departure.  In  the 
African  Avars,  the  soldiers  carried  six  packages  of  car- 
tridges, and  provisions  for  eight  days.  Furthermore, 
the  large  canteens,  large  bowls  and  kettles,  must  be 
carried  by  a  detachment  of  eight  men. 

It  will  be  admitted,  that  opportunities  were  afforded 
for  studying  these  details  in  the  Crimea,  when  it  is  re- 
membered that  cold  weather  was  just  coming  on,  that 
the  army  had  suffered  greatly  during  the  previous  winter, 
and  that  endeavors  should  be  made  to  spare  it  as  much 
as  possible  from  new  exposures,  by  turning  to  account 
past  experience  and  the  counsels  of  hygienic  science. 

Having  made  this  research  into  the  best  means  for 
preserving  the  health  of  our  army,  I  reduced  my  views 
into  the  following  report,  addressed  November  10th, 
1855,  to  the  Minister  of  War  : 

"To  His  EXCELLENCY  THE  MARSHAL. — My  duties 
have  been  actively  applied  to  the  threefold  question  of 
food,  shelter,  and  clothing. 

"  It  is  true,  our  army  has  no  longer  to  endure  the 
miseries  of  the  trenches  ;  but  instead  of  old  soldiers,  it 
consists  at  this  time  of  one-third  if  not  a-half  recruits ; 
young  beardless  soldiers,  with  at  most  but  a  year  of  ser- 


56  THE   CRIME  AX   WAK. 

vice.  Last  winter,  they  each  received  daily  an  extra 
pay  of  half  a  franc  on  account  of  siege  work.  As  this 
resource  will  be  cut  off,  the  daily  allowance  will  suffer 
to  that  extent.  The  army  was  fed  last  winter  with 
great  care,  but  still  the  number  of  sick,  for  the  first  five 
months  of  the  cold  season,  was  high.*  It  is  highly 
important  to  remember,  that  the  army  is  now  much 
more  numerous  than  then ;  it  numbers  at  this  time  over 
140,000  men. 

"  1st.  Of  the  Shelters. — To  the  troops  encamped  in  the 
forest  of  Baidar,  I  advise  the  building  of  huts  buried  a 
yard  and  a  half  in  the  ground,  with  roofs  of  double 
slope  made  of  brush,  covered  with  earth,  or  better 
still,  sodded.  At  the  bottom  of  the  room  there  should 
be  a  fireplace  opposite  to  the  door,  which  should  be 
constantly  fed  with  wood  from  the  forest,  to  renew 
the  air,  especially  in  its  lower  strata,  to  dry  the 
walls,  and  to  render  a  habitation  that  otherwise  would 
generate  typhoid  fevers  and  scurvy,  a  warm  and  healthy 
abode.  Where  wood  and  water  abound,  the  soldier 
is  happy.  Instead  of  carrying  bread  to  the  distant 
cantonments  of  Baidar,  we  sent  sacks  of  flour,  which 
was  made  into  bread  on  the  ground,  thus  economizing 

*  The  following  statement  shows  the  sanitary  condition  of  the 
French  army  in  the  field  hospitals  of  the  ^Crimea,  in  the  winter  of 
1854-5: 

Months.           Effective  Strength.  Sick. 

October 46,000  3,200 

November 55,000  5,000 

December 65,000  6,000 

January 75,000  9,000 

February 88,000  8,000 

These  figures  do  not  include  the  sick  in  the  regimental  infirmaries. 
The  hospitals  at  Constantinople  presented  during  the  same  period  the 
following  conditions  on  the  25th  of  each  month : 

Months.  Sick  present.  Sick. 

October 3,235  1,447 

November 3,486  2,695 

December 4,414  2,427 

January 7,031  4,084 

February 7,386  4,905 

AUTHOR'S  NOTE. 


THE    CRIMEAN    WAR.  57 

the  wood  which  came  to  Kamiesch  from  Varna.  This 
forest,  in  a  hygienic  point  of  view,  fulfilled  expectations. 
The  six  weeks  which  three  divisions  of  the  first  corps 
spent  there,  could  not  have  been  more  favorable  to 
the  health  of  the  troops,  and  especially  that  of  the 
recruits. 

"The  camps  placed  upon  the  undulating  plateaux  of 
the  Crimea,  were  also  in  perfect  health.  Unfortunately 
not  a  single  tree  was  left ;  and  the  subterranean  forest, 
that  is,  the  roots  of  trees  cut  down  the  year  before,  are 
nearly  exhausted.  It  is  useless  to  think  of  building 
huts,  tents  must  be  resorted  to.  Where  the  soil  was 
calcareous,  they  dug  a  circular  pit,  some  two  feet  deep, 
in  which  the  tent  was  placed,  making  a  gutter  around 
it,  for  drawing  off  the  rain  water.  The  materials  taken 
out  served  to  build  a  wall  around  it,  about  two  feet 
high,  so  that  the  soldier,  when  in  bed,  was  sheltered 
entirely  from  the  wind  and  the  rain.  The  shelter  would 
have  been  complete  had  they  added  a  fireplace,  as  in 
the  officers'  tents.  Where  the  soil  was  not  calcareous, 
the  arrangement  was  sooner  made,  but  not  as  good,  for 
the  circular  bank,  in  form  of  a  parapet  made  around  the 
tent,  was  not  to  be  compared  with  the  wall  of  dry 
stones,  and  the  ditches  had  to  be  paved,  to  hinder  the 
water  from  filtering  into  the  inside  of  the  tent.  It  is 
necessary  to  furnish  the  men  with  either  a  sheepskin 
or  a  plank  (biscuit  boxes  answer  the  purpose),  to  keep 
them  from  the  ground,  and  a  piece  of  oiled  cloth  which 
they  could  form  into  a  mantle,  by  wrapping  it  around 
them  on  rainy  days. 

"  The  shelter-tent  is  entirely  insufficient  for  winter,  and 
it  is  so  short  that  it  does  not  cover  the  feet  of  the  men. 
It  may  be  advantageously  replaced  by  the  conical  tent, 
fashioned  after  those  of  the  Turks,  of  all  tents  the  warm- 
est and  strongest  to  resist  a  gale  of  wind.  Tents  should 
always  be  set  as  far  apart  as  possible,  and  when  the 
weather  permits,  should  be  moved  at  least  every  four 
days.  When  the  sun  shines  the  contents  should  be 
exposed  to  the  air,  and  the  tents  should  themselves  be 
taken  down ;  but  unfortunately  this  very  essential 
requirement  is  not  attended  to,  even  in  the  field  hospi- 

4 


58  THE    CRIMEAN    AVAR. 

tals.  It  should  be  signalled  by  tap  of  the  drum,  which 
never  fails  to  catch  the  ear  of  the  soldier. 

"  Board  barracks  would  be  better  than  tents,  when  the 
joints  of  the  roof  boards  are  tight,  but  this  shelter  is 
exceptional  and  limited  entirely  to  the  sick  in  the  regular 
and  field  hospitals,  and  the  regimental  infirmaries. 

"If  we  help  the  soldier  a  little,  he  will  help  him- 
self. Stones  abound  everywhere,  and  of  them  the  four 
walls  of  a  house  may  be  easily  built,  and  we  have  only 
to  furnish  boards  for  the  roof,  to  have  quickly  con- 
structed, and  at  small  expense,  a  range  of  comfortable 
houses,  to  shelter  the  men  from  drenching  rains,  and  to 
dry  their  clothes  when  wet.  Without  a  fire,  they  will 
wear  their  wet  clothes  more  than  a  week,  and  this  causes 
many  diseases,  which  must  be  expelled  from  the  army. 
When  stone  cannot  be  had,  I  would  advise  that  the 
walls  be  made  of  gabions,  sand  bags  from  the  trenches, 
butts,  and  biscuit  boxes. 

"  For  three  days,  there  have  been  distributing  to  the 
army  the  building  materials  found  in  Sebastopol.  Thus 
use  is  made  of  the  town,  which  is  being  gradually  wasted 
by  Russian  cannon.  I  examined  the  materials  with  care, 
and  found  a  large  quantity  of  plank,  carpenter's  wood, 
and  tiles,  besides  a  great  number  of  large  iron  kettles, 
which  we  shall  use  for  making  soups  for  the  hospitals. 
These  resources,  apportioned  discreetly,  will  be  of  great 
benefit ;  and  within  a  month,  if  the  fine  weather  should 
continue,  our  camps,  which  are  the  scene  of  wonderful 
activity,  will  be  completely  transformed. 

"  2d.  Of  the,  Clothing. — The  Crimean  cloak  has  been 
of  great  service,  and  it  is  urged  that  it  should  be  fur- 
nished to  all  the  soldiers.  They  have  nevertheless  done 
wrong  by  wearing  it  in  summer,  instead  of  keeping  it  for 
bad  weather  in  winter.  This  abuse  of  it  renders  them 
sensitive  to  the  cold,  and  exposes  them  to  the  effects  of 
vicissitudes.  The  flannel  girdle  is  indispensable,  in  pre- 
venting and  checking  the  diarrhoeas  that  are  so  common, 
and  that  so  often  run  into  dysenteries  and  other  very 
serious  maladies.  It  should  be  applied  in  direct  contact 
with  the  body.  Our  old  soldiers  know  its  usefulness, 
but  it  is  not  easy  to  make  the  recruits  wear  it.  I  invoke 


THE    CRIMEAN   WAR.  59 

for  the  enforcement  of  this  regulation,  the  vigilance  of 
all  commanding  officers  and  regimental  physicians. 

"In  winter,  we  distribute  to  the  troops  another  half- 
blanket,  to  be  used  with  that  given  them  for  summer 
use.  This  blanket  loads  down  the  soldier  on  the  inarch. 
When  it  becomes  damp,  as  it  does  by  the  first  rain, 
it  can  hardly  be  said  to  get  thoroughly  dry  the  whole 
winter.  I  am  convinced  it  could  be  profitably  replaced 
by  a  red  woollen  shirt,  like  that  worn  by  the  English. 
A  woollen  shirt  keeps  up  a  pleasant  and  uniform  warmth. 
Every  man  should  have  two,  which,  at  75  cents  each, 
would  amount  to  $1.50,  or  about  the  price  of  a  blanket. 
The  men  would  be  less  loaded,  and  they  would  have 
next  to  the  skin^a  warm,  dry,  and  perfectly  healthy 
garment.  Flannel  shirts  ought  to  come  into  general 
use  in  our  infirmaries  and  field  hospitals,  where  they 
would  prevent  and  cure  many  diseases. 

"  The  wooden  shoes,  which  our  soldiers  use  as  a  change 
for  their  wet  shoes,  are  indispensable  in  a  country  where 
the  ground  is  trampled  up  to  a  considerable  depth  ;  and 
during  the  last  winter,  the  men  whose  shoes  were  frozen 
hard  for  many  days,  could  not  have  gone  out  had  it  not 
been  for  these  wooden  shoes.  Socks  are  very  useful, 
and  not  only  supply  an  indispensable  outfit  for  walking 
in  wood,  but  are  also  of  precious  use  during  the  night, 
in  keeping  the  feet  from  freezing.  It  might  be  difficult 
to  supply  them  for  the  whole  army,  but  General  Bazaine 
has  assured  me,  that  in  every  company  there  may  be 
found  men  who  will  knit  them  for  their  comrades  for  a 
very  moderate  price.  Besides,  with  some  of  those 
ingenious  machines  of  which  models  were  shown  at  the 
great  Paris  exhibition  of  1855,  we  might  be  readily 
supplied. 

"  3d.  Of  the  Food. — We  cannot  too  highly  praise  the 
department  of  subsistence  for  having  so  happily  solved 
the  difficult  problem,  of  provisioning  an  army  eight  hun- 
dred leagues  from  France ;  and  at  no  other  period  in 
our  military  history,  has  the  daily  issue  of  rations  been 
made  with  more  regularity.  It  did  not  fail  a  single  day, 
and  the  alternation  of  fresh  bread  and  biscuit,  of  coffee, 
wine,  and  brandy,  and  of  fresh  meat,  preserved  meat, 


60  THE   CRIMEAN    AVAK. 

and   lard,  was  conducted  with   facility,  breaking  the 
uniformity  of  food,  and  resulting  in  general  health. 

"  The  supplies  most  needed  were  fresh  vegetables,  and 
to  this  want,  as  well  as  to  the  cold  and  damp  habita- 
tions, and  to  sleepless  nights  spent  in  the  trenches,  was 
to  be  ascribed  the  scurvy,  which  so  seriously  embar- 
rassed the  army.  To  supply  the  want  of  fresh  vegeta- 
bles, an  abundance  of  preserved  mixed  vegetables  should 
be  provided,  sourkrout,  potatoes,  and  onions ;  they  are 
the  best  for  the  soldier's  use.  Seeds  for  sowing  culinary 
gardens,  and  especially  radish  seeds,  should  be  dis- 
tributed to  the  companies,  and  it  would  be  desirable  to 
supply  the  mess  with  condiments,  such  as  cloves,  long 
pepper,  nutmegs,  and  laurel  leaves.  *  Thyme  abounds 
here,  and  I  advise  its  use  in  seasoning  soups.  Cargoes  of 
oranges  and  lemons,  sent  to  the  Crimea,  will  be  necessary 
in  treating,  and  even  in  preventing,  scorbutic  affections. 
Of  vegetable  acids  the  army  of  the  East  had  long  been 
deprived." 

I  addressed  a  copy  of  this  report  to  Marshal  Pelissier, 
and  to  M.  Blanchot,  the  intendant-general  of  the  army. 
In  a  reply  received  from  the  latter,  he  said : — "  I  observe 
with  pleasure,  that  most  of  theliygienic  measures  advised 
by  you  have  been  executed,  and  we  have  gone  even 
farther  than  you  require,  in  regard  to  clothing.  You 
seem  to  regard  it  as  difficult  to  furnish  the  whole  army 
with  socks,  but  I  am  happy  to  inform  you,  that  in  the 
coming  winter  every  soldier  will  have  not  only  a  pair  of 
socks,  but  likewise  a  pair  of  woollen  stockings,  and  a 
pair  of  long  gaiters."  It  will  be  seen  that  my  hygienic 
views  agreed  entirely  with  the  plans  of  the  intendant- 
general  of  the  army.  The  result  of  these  studies 
will  show  that  my  medical  and  surgical  suggestions 
were  also  uniformly  sanctioned  by  the  Minister  of  War, 
and  by  the  Marshal  commanding  in  the  East.  We  can 
never  form  too  high  an  estimate  of  the  services  which 
medical  science  can  render  to  an  army  in  the  field, 
and  of  the  influence  that  it  may  exert  upon  the  vicissi- 
tudes of  war.  Its  counsels,  which  are  not  always  asked 
or  heard  until  suffering  and  death  make  us  cruelly  feel 
their  value,  might  have  saved  many  a  man  who  has 


THE   CRIMEAN   WAR. 


61 


lost  or  imperilled  by  imprudence,  a  life  of  which  the 
nation  had  need.  The  preservation  of  the  soldier, 
sent  out  at  great  expense,  is  the  first  thing  of  interest 
to  a  people  who  may  be  conducting  a  foreign  war,  and 
it  is  the  first  pledge  of  success.  Diseases  slay  more 
men  than  steel  and  powder,  and  it  is  often  easy  to  pre- 
vent them  by  a  few  simple  hygienic  precautions.* 

*  The  history  of  the  United  States  has  hitherto  afforded  but  slender 
materials  for  statistical  deductions  of  the  sickness  of  armies,  and  of 
losses  by  war.  In  the  Mexican  war,  the  standing  army  was  increased 
by  ten  new  regiments,  and  a  large  volunteer  force,  which  was  mus- 
tered out  of  the  service  upon  the  peace.  The  following  summaries 
show  that  there  occurred  most  extraordinary  percentages  of  losses 
from  disease,  as  compared  with  those  by  death  or  disability  from 
battle:— 


Old  Esta- 
blishment. 

Ten  New 
Regim'ts. 

Volun- 
teers. 

Total. 

Aggregate  officers  and  men  
Average  length  of  service  (months). 
Discharged  by  expiration  of  service. 
"           for  disability. 

15,736 
26 

1,561 
1  782 

11,186 
15 
12 

767 

73,532 
10 
50,573 

7200 

100,454 

52,146 
9749 

by  order  of  civil  authority 
"           total  

373 
3716 

114 
893 

2.016 
9216 

2.503 
13825 

Deaths,  killed  in  battle,  officers  
"       men  
died  of  wounds,  officers  
"           "           "           men 

'  41 

422 
22 
807 

5 
62 
5 

71 

47 
467 

100 

'93 
951 

27 

478 

"       total    killed     and    died    of 
wounds,  officers  

63 

10 

47 

120 

"            "        "      men 

729 

133 

567 

1429 

"        ordinary,  officers 

49 

36 

"           men  
accidental  

2,574 
139 

2,055 
30 

i    6,256 
192 

10,885 
861 

"        aggregate  

3554 

2264 

7078    ' 

12  896 

Wounded  in  battle,  officers  

118 

'  86 

129 

283 

men  

1  685 

236 

1  189 

8110 

Resignations  

87 

92 

827 

456 

Desertions  

2,247 

602 

8,876 

6,725 

TE. 


PAKT    II. 

THE  FIELD    HOSPITAL   AND    MEDICAL   SER- 
VICE. 

OUR  army  of  the  East  had  three  kinds  of  health  esta- 
blishments, corresponding  with  the  three  grades  of 
treatment.  The  infirmaries  and  ambulances  of  the 
trenches,  were  the  first  to  receive  the  sick  and  wounded ; 
those  who  were  suffering  more  seriously,  went  to  the 
field  hospitals  of  Divisions ;  and  lastly,  in  addition  to 
these,  were  the  regular  hospitals,  placed  beyond  the  seat 
of  war,  and  receiving  the  sick  that  required  a  long 
and  careful  treatment.  Having  begun  my  inspection  in 
the  Crimea,  I  first  had  to  notice  the  infirmaries  and  field 
hospitals,  and  my  first  observations  were  directed  to  the 
Surgical  Service. 


CHAPTER    I. 

•THE   INFIRMARIES   AND   FIELD   HOSPITALS. 

WE  were  unable  to  establish  definitively  the  regimental 
infirmaries,  until  after  the  taking  of  Sebastopol.  Until 
then,  the  temporary  nature  of  the  bivouacs  prevented 
their  proper  arrangement,  and  only  the  parks  of  ar- 
tillery, and  the  engineers,  were  settled  and  had  their 
infirmaries  under  barracks.  That  of  the  artillery  park, 
at  head-quarters,  embraced  everything  that  could  be 
desired,  and  was  ably  conducted.  It  had  around  it  a 
vegetable  garden,  exclusively  reserved  for  the  sick,  thus 
improving  and  varying  their  regular  allowances.  This 
infirmary  sent  but  few  sick  to  the  field  hospitals,  or  to 
the  regular  hospitals. 


THE   CRIMEAN   WAE.  63 

The  recruits  who  arrived  during  the  autumn  of  1855 
had  to  undergo  at  the  same  time  a  change  of  climate,  a 
new  kind  of  life,  and  a  rigorous  winter,  and  it  was  to  be 
apprehended  that  they  would  furnish  many  inmates  to 
our  hospitals.  In  view  of  this  unhappy  prospect,  Mar- 
shal Pelissier  prescribed  and  allowed  to  each  regiment, 
two  barracks  for  infirmaries.  I  would  have  wished  that, 
to  prevent  crowding,  the  important  measure  had  also 
been  adopted  of  sending  to  Constantinople  fifteen  thou- 
sand of  the  soldiers,  who  were  ailing,  and  too  accessible 
by  disease,  they  would  have  then  passed  a  mild  winter  in 
comfortable  quarters  ;  but  it  was  impossible  to  act  upon 
my  suggestion.  At  least  the  reorganization  under  bar- 
racks of  infirmaries  forty  beds  to  a  corps,  served  to  furnish 
the  army  with  new  shelters  for  twenty-four  hundred  sick. 

The  internal  arrangement  varied  according  to  the 
regiments,  and  while  some  of  the  barracks  were  chinked 
up  and  very  close,  others  were  open  to  the  day,  the 
joints  between  the  boards  admitted  the  rain,  and  although 
the  stoves  were  always  burning  the  cold  was  intense. 
The  corps  of  engineers  was  blamed,  as  if  it  could  do 
everything.  It  had  built  the  barracks,  and  closed  the 
joints  with  battens,  and  if  the  dryness  had  drawn  the 
wood  apart,  the  inmates  should  have  repaired  it.  In 
some  infirmaries,  the  sick  had  beds  made  of  strong  cloth 
stretched  upon  wrooden  frames,  or  bundles  of  boughs 
covered  with  little  mats,  but  all  the  others  were  reduced 
to  the  dirty  plank  of  the  camp  bed.  Most  of  the  bar- 
racks were  whitewashed  with  lime  within,  and  disinfected 
with  chlorine,  but  these  healthful  measures  were  some- 
times neglected.  The  diet  presented  the  same  irregu- 
larities, and  while  in  some  a  small  amount  of  funds 
reserved  from  the  wages  for  labor  allowed  of  improving 
and  varying  the  food,  in  others,  nothing  was  changed 
from  the  ordinary  regimen  of  the  soldier,  the  modifica- 
tion being  only  a  diminution  of  quantity.  Cleanliness 
was  everywhere  wanting.  Such  an  indifference  is  truly 
incomprehensible.  In  each  infirmary  there  were  fifteen 
or  twenty  men,  limping,  listless,  and  idle,  and  yet  they 
were  not.  employed  to  clean  their  own  room  !  And 
negligence  was  tolerated  which  endangered  the  health  of 


64  THE   CKIMEAX   WAR. 

the  sick !  Would  it  not  be  practicable  to  inspire  more 
system  in  the  hospital  service  throughout,  by  leaving  a 
large  part  to  the  watchfulness  of  the  colonels,  who 
might  be  aided  by  rules  carefully  prepared?  In  a 
campaign,  without  doubt,  we  must  do  as  we  can,  for 
our  means  are  often  scanty,  but  still  we  should  see 
that  what  is  indispensable  should  never  be  wholly 
wanting. 

In  two  or  three  infirmaries  only,  I  found  a  special 
register  giving  the  names  of  the  men  of  the  corps  who 
had  been  wounded  by  the  enemy  since  the  beginning  of 
the  war,  and  the  date,  the  place,  the  severity,  and  the 
result  of  the  lesion.  It  is  to  be  regretted  that  this  ex- 
ample was  not  more  generally  followed,  and  that  it  was 
not  prescribed  as  a  regular  requirement.  The  authen- 
ticity of  "these  documents  would  render  them  very  use- 
ful for  statistical  and  other  reports.  It  would  be  the 
golden  book  of  the  regiment,  its  titles  of  nobility. 

The  good  arrangement  of  infirmaries  is  of  great  im- 
portance. Being  the  first  asylum  of  the  sick  and 
wounded,  they  should  send  to  the  field  hospitals  of 
divisions,  or  to  the  regular  hospitals,  those  who  require 
a  long  treatment.  In  those  badly  arranged  the  most 
simple  ailment  may  become  severe  and  degenerate  into 
a  long  course  of  disease.  In  a  healthy  climate  like 
the  Crimea  most  of  the  diseases  are  at  first  light,  and 
may  be  checked  at  the  outset  by  a  little  repose  and 
careful  attention ;  but  if  these  hygienic  precautions  are 
inadequate,  the  field  hospitals  become  encumbered.  To 
check  an  ailment  in  its  early  stages  by  applying  imme- 
diately the  first  remedies ;  such  is  the  use  of  the  infirm- 
aries. As  for  the  wounded  in  battle,  the  first  dress- 
ings are  almost  always  applied  in  the  ambulances  of  the 
trenches. 

Some  eighteen  hundred  yards  from  Sebastopol,  we 
find  hidden  in  a  snug  little  valley,  a  little  farm-house  of 
humble  appearance,  which  I  never  could  look  upon 
without  respectful  emotion.  This  place  had  served  as 
the  ambulance  of  the  trenches  for  the  works  of  the  left 
division.  Established  when  the  siege  began,  at  the  far 
renowned  house  called  the  Clocheton,  the  field  hospital 


THE   CRIMEAN    WAR.  65 

was  forced  by  the  enemy's  fire,  which  was  unceasing, 
to  retire  into  the  nook  where  this  little  farm-house  stood  ; 
the  bearers  of  litters  brought  in  the  wounded  con- 
tinually, and  on  the  night  of  May  1-2,  1855,  four  hun- 
dred entered.  As  the  works  of  the  siege  advanced,  the 
hospital  spread  itself;  tents  and  barracks  grouped  round 
the  original  building.  A  worthy  chaplain  from  the  fleet 
resided  with  the  physician.  Religion  and  science  united 
to  solace  the  pains  of  the  wounded,  to  inspire  a  hope  of 
life,  or  soften  the  hour  of  death.  A  piece  of  ground 
inclosed  with  walls,  was  used  as  a  burial-place,  where 
each  officer  had  a  separate  grave,  while  the  soldiers 
reposed  together  in  great  common  graves  ; — companions 
in  arms  and  in  dangers,  death  itself  did  not  separate 
them.  After  the  fall  of  Sebastopol,  this  field  hospital 
became  a  shrine  of  pilgrimage,  where  each  one  sought 
the  tomb  of  a  friend.  Well  might  a  chapel  be  erected 
there  in  honor  of  so  many  courageous  men,  struck  down 
without  distinction  in  the  painful  labors  of  the  siege. 

Two  caves  used  as  ambuscades  by  the  Russians,  in  the 
ravines  of  Carenage,  and  of  Karabelnaia,  served  as  field 
hospitals  for  the  trenches  of  the  right.  They  were  shel- 
tered from  balls  fired  in  direct  range,  but  more  than 
one  bomb  rolled  down  the  ravines,  exploding  and  mak- 
ing victims  at  the  doors  of  these  sad  retreats,  the  habi- 
tations of  suffering.  Only  a  straggling  light  penetrated 
these  recesses  by  day,  rendering  surgical  operations  diffi- 
cult ;  and  at  night,  only  one  small  lamp  was  suspended 
from  the  roofs  so  as  not  to  attract  the  notice  of  the 
enemy.  In  the  midst  of  the  continued  and  deafening 
thunders  of  the  cannonade,  might  be  heard  at  intervals 
the  cries  of  the  birds  of  prey,  as,  disturbed  in  their 
wonted  homes  among  the  cliffs,  they  plunged  down,  and 
bore  away  the  rags  of  human  flesh  which  were  scat- 
tered around.  After  the  taking  of  the  city,  we  went 
with  pious  reverence  to  visit  these  grottoes,  peopled 
with  so  many  gloomy  memories.  They  showed  us  the 
litter  of  straw,  still  bloody,  where  the  surgeon  had  knelt 
to  extract  a  ball,  or  stop  a  haemorrhage.  Who  can 
ever  tell  all  of  the  sad  and  pitiful  scenes  which  these 
places  have  witnessed ! 

4* 


66  THE   CRIMEAN   WAR. 

In  these  ambulances  of  the  trenches,  gaping  wounds 
and  broken  limbs  received  their  first  dressings ;  the 
blood  which  flowed  in  abundance,  was  checked  by  hasty 
appliances ;  many  entered  only  to  die,  after  cruel  agonies, 
with  heroic  courage,  while  the  remainder  were  trans- 
ferred to  the  field  hospitals  of  Division. 

The  fourteen  Divisions  of  the  Crimean  army  were 
each  provided  with  a  field  hospital,  but  they  sometimes 
simplified  the  labor,  by  giving  one  only  to  two  Divisions, 
and  in  this  case  it  was  always  a  double  size.  The  Divi- 
sions were  arranged  into  three  corps,  to  each  of  which 
was  attached  a  head  physician.  Each  field  hospital 
had  eight  doctors,  two  majors,  and  six  aid-majors. 
The  apothecary  service  was  intrusted  to  one  or  two 
military  apothecaries,  under  one  faculty.*  The  number 

*  The  medical  officers  of  the  French  service  rank  as  follows  in  the 
descending  series,  with  the  total  number  in  the  army  of  each  grade. 

7  Medical  Inspectors. 

40  Principal  Physicians  of  the  first  class. 

40  Principal  Physicians  of  the  second  class. 

330  Major  Physicians  of  the  first  class. 

260  Major  Physicians  of  the  second  class. 

400  Aides  Major  Physicians  of  the  first  class. 

400  Aides  Major  Physicians  of  the  second  class. 

300  Sub-aide  Physicians. 

The  apothecaries  are  divided  into  like  classes,  with  corresponding 
names,  but  their  numbers  are  less,  viz.:  1,  5,  5,  17,  34,  50,  50,  and  160 
respectively.  These  numbers  are  alike  in  peace  and  war,  and  they 
bear  no  corresponding  relation  with  military  grades.  Physicians  and 
apothecaries  from  civil  life  are  commissioned  as  auxiliaries  for  special 
emergencies  according  to  the  wants  of  the  service. 

The  functions  of  the  several  grades  of  medical  officers  are  defined  as 
follows : 

The  Medical  Inspectors,  designated  by  the  Minister  of  War,  acting 
collectively,  constitute  the  Council  of  Health  of  the  army.  The 
Inspector  of  oldest  commission  presides,  and  the  Board  is  charged 
with  overseeing  and  directing  all  that  pertains  to  the  healing  art,  in 
every  branch  of  the  health  service,  and  with  assisting  the  Minister  of 
"War  upon  all  subjects  to  which  these  questions  relate.  They 
maintain  a  correspondence  with  the  medical  officers  of  hospitals  and 
corps  of  troops,  and  with  the  chief  health  officers  of  the  armies,  in  all 
that  concerns  the  science  and  art  of  healing.  They  advise  in  the 
designation  of  medical  officers  in  the  various  departments  of  the 
sanitary  service,  upon  information  derived  from  the  notes  or  reports 
of  the  persons  engaged  in  the  two  professions,  and  from  the  evidences 


THE   CRIMEAN   WAE.  6V 

of  infirmaries  increased  in  proportion  with  the  sick, 
and  the  medical  service  was  apportioned  according  to 
their  wants.  When  a  part  of  the  division  made  a  move- 
ment, it  was  followed  by  a  part  of  the  field  hospital, 
under  the  care  of  the  second  major  physician,  and  two 
aids.  The  stores  carried  upon  ammunition  wagons 
or  the  backs  of  mules,  were  greater  or  less  in  quantity, 
according  to  the  probable  wants,  and  the  facilities  for 
transportation.  They  were  often  compelled  to  leave 
behind  the  ambulance  caissons,  and  to  march  with  only 
a  few  chairs  or  litters,  to  bring  back  the  sick  and 
wounded. 

At  the  opening  of  the  war,  the  field  hospitals  of  Divi- 
sions were  in  tents.  The  barracks  arrived  at  a  later 
period,  and  became  more  and  more  numerous.  At  the 

shown  by  the  examinations  of  the  major  physician,  undertaken  with 
the  view  of  ascertaining  special  aptitude  for  the  functions  of  the 
physician  or  the  surgeon.  Individually,  the  Inspectors  are  charged 
with  the  duty  of  annual  or  extraordinary  medical  inspections,  under 
special  instructions.  They  may  be  employed  in  the  direction  of  the 
medical  service  of  the  armies,  and  upon  such  special  missions  as  the 
Minister  of  War  may  assign. 

The  Principal  Physicians  are  attached  to  the  corps  of  armies  in 
campaign,  and  perform  for  their  commanders,  duties  analogous  to  those 
of  the  Council  of  Health  to  the  Minister.  They  are  employed  as  chiefs 
of  the  medical  service,  in  hospital  establishments  whether  civil  or 
military,  and  in  this  respect  their  functions  are  determined  by  the 
regulations  of  the  hospital  service. 

The  Major  Physicians,  of  the  first  and  second  class,  are  employed  as 
practising  physicians  in  hospitals,  and  as  chiefs  of  the  health  service 
in  corps  of  troops.  Their  fitness  for  this  service  is  previously 
ascertained  by  examinations,  of  which  the  programme  is  arranged  by 
the  Council  of  Health. 

The  Aides  Major  Physicians  have  their  two  classes,  each  divided 
into  two  sections,  in  order  to  facilitate  the  rotation  of  these  officers  in 
the  hospitals  and  regiments,  so  as  to  prevent  them  from  remaining  too 
long  in  any  one  part  of  the  service.  They  have  the  immediate  charge 
of  the  sick,  and  their  duties  nearly  correspond  with  those  of  surgeons 
in  the  American  service. 

The  Sub-aide  Physicians,  like  the  Assistant  Surgeons  of  the  U.  S., 
render  medical  assistance  in  the  regiments  and  hospitals,  and  are 
often  placed  in  charge  of  detached  bodies  of  troops,  and  small  posts. 

The  Auxiliary  Physicians,  commissioned  by  the  Minister  of  War,  or 
employed  by  the  Military  Intendants,  are  employed  in  the  duties  of 
Aide-Major,  and  cannot  be  intrusted  with  those  of  Major  Physicians, 
except  in  default  of  such  officers  in  the  service.— M. 


68  «  THE    CRIMEAN    WAK. 

close  of  the  year  1855,  they  could  lodge  from  four 
thousand  to  five  thousand  sick.  At  that  time,  the 
Minister  of  War  sent  six  thousand  new  mattresses,  an 
immense  quantity  of  blankets,  beyond  even  their  wants, 
and  a  considerable  amount  of  stores.  It  was  not 
easy  to  take  care  of  all  this  in  a  campaign  ;  every 
moment,  unforeseen  difficulties  arrest  the  best  inten- 
tions; thus  during  the  most  rigorous  part  of  the 
winter  of  1855-6,  it  was  impossible  to  wash  the  bed 
clothing  properly.  To  lessen  the  great  consumption  of 
linen  bandages,  it  was  desirable  they  should  be  washed, 
so  as  to  be  used  again,  but  there  was  no  laundry. 
It  became  necessary  to  burn  them,  so  as  to  preserve 
the  hospital  from  the  putrid  emanations  which  they 
gave  out.  The  surgeons  in  the  field  should  be  econo- 
mical in  the  use  of  lint  and  linen  compresses,  the  supply 
becomes  more  difficult  to  renew  in  proportion  as  cotton 
is  more  generally  employed  as  a  substitute  for  linen  and 
hemp.  Carded  cotton  increased  our  resources,  and  a 
compress  of  wadding  maintains  a  pleasant  and  uni- 
form heat ;  it  is  an  excellent  dressing,  and  well  to  recom- 
mend. It  is  true,  wadding  is  not  an  absorbent,  but  this 
inconvenience  is  obviated  by  placing  between  it  and 
the  wound  some  tufts  of  lint. 

The  diet  in  the  field  hospitals  of  Divisions  was  essen- 
tially the  same  as  that  of  the  hospitals  in  France,  except 
such  accidental  modifications  as  were  imposed  by  unfore- 
seen events.  Broth  was  never  wanting,  and  besides  meat 
and  vegetables,  the  field  hospitals  received  minced  pies, 
eggs,  prunes,  sweetmeats,  chocolate,  and  wine.  They 
were  even  furnished  with  cans  of  preserved  milk  of  the 
consistence  of  butter,  which  was  diluted  with  three 
or  four  times  its  volume  of  water  when  used.  It 
retained  its  properties,  even  after  several  days'  exposure 
to  the  open  air.  The  physicians  sometimes  distributed 
Bordeaux  wine,  derived  from  the  national  gifts.  These 
field  hospitals  were  of  course  moved  many  times  during 
the  war,  and  the  following  history  of  the  field  hospital 
of  the  3d  division  of  the  2d  corps  will  serve  as  an 
example  of  the  rest. 

On  the  20th  of  September,  this  field  hospital  was  divi- 


THE   CRIMEAN   WAE.  69 

ded  at  Alma  into  two  parts,  of  which  one  was  established 
on  the  battle-field,  and  the  other  in  the  train  of  the  Divi- 
sion. Four  hundred  wounded,  of  whom  a  hundred  were 
Russians,  were  attended  to  during  the  night,  and  at  once 
embarked.  Fifteen  amputations  were  performed.  Ar- 
riving under  the  walls  of  Sebastopol,  the  field  hospital 
was  established  in  the  ruins  of  a  Tartar  farm-house,  and 
received  the  first  wounded  of  the  siege.  On  the  6th  of 
November,  the  day  of  the  battle  of  Inkermann,  a  sec- 
tion was  detached  to  go  to  the  camp  of  the  Moulin.  It 
received  400  wounded  Russians,  and  as  it  was  easier  to 
bring  tents  than  remove  the  wounded,  they  remained  for 
the  time  on  the  field  of  battle,  with  a  brigade  of  the 
Division.  They  had  pitched  temporarily  upon  the  place 
of  combat,  without  regard  to  choice  of  site,  and  bad 
weather  subsequently  prevented  them  from  removing  it 
elsewhere,  or  even  from  enlarging  it.  It  was  upon  a 
flat  piece  of  ground,  sheltered  and  hedged  in  on  every 
side  by  the  French  and  English  camps ;  but  it  was  near 
the  siege  works,  at  the  entrance  of  the  ravine  of 
Carenage,  and  near  that  of  Karabelnaia,  and  into  it 
the  ambulances  of  the  trenches  emptied  the  greater 
part  of  their  wounded.  After  one  of  the  night  combats, 
which  were  so  murderous  and  so  frequent  during  the 
winter  of  1855,  one  hundred  and  thirty  great  operations 
were  performed  within  twenty-four  hours. 

Meanwhile,  the  3d  Division  of  the  2d  corps  had  sus- 
tained many  cruel  losses ;  its  most  valiant  chiefs  had 
fallen  at  its  head,  and  its  effective  strength  was  reduced 
to  3,000  men.  It  received  orders  to  move  upon  the 
Tchernaia,  and  there  replace  the  1st  division.  Each 
Division  left  its  field  hospitals  and  its  sick  in  their  respec- 
tive positions,  the  medical  staff  and  hospital  staff  being 
only  changed,  by  passing  from  one  field  hospital  to  the 
other. 

Thus,  the  field  hospital  of  which  we  have  spoken, 
changed,  so  to  speak,  its  Division  but  not  its  locality. 
Scarcely  a  hundred  yards  separated  it  from  the  reserved 
artillery  parks  of  the  French  and  English.  On  the  16th 
of  Nov.,  1855,  at  about  four  o'clock  in  the  afternoon, 
three  fearful  explosions,  echoed  from  the  mountains  in 


70  THE   CRIMEAN   WAE. 

a  prolonged  roll,  shook  suddenly  the  soil  of  the  Crimea, 
and  announced  some  terrible  accident.  A  high  column 
of  flame  and  smoke  rising  in  the  direction  of  the 
mill  of  Inkermann,  marked  the  spot  where  three 
magazines  of  our  grand  park  of  artillery,  containing 
66, 120  pounds  of  powder,  600,000  cartridges,  300  loaded 
bombs,  and  other  appliances  of  war  had  exploded.  The 
burning  materials,  thrown  to  a  great  distance,  set  fire  to 
the  English  park  near  us,  and  occasioned  partial  explo- 
sions and  a  great  conflagration.  We  had  100  wounded 
and  30  killed,  while  the  English  lost  24  killed  and  112 
wounded.  The  misfortune  would  have  been  still  more 
serious,  had  it  not  been  for  the  vigilance  of  Marshal 
Pelissier,  who  directed  in  person  all  the  measures  for 
safety.  The  field  hospital  barracks  were  thrown  over 
like  a  pack  of  cards  upon  the  poor  sick,  but  happily 
only  a  few  were  bruised.  Five  physicians  in  the  field 
hospital  were  hurt,  so  as  to  be  incapable  of  performing 
their  duties,  but  nevertheless,,  during  the  evening,  all 
the  wounded  had  received  the  necessary  care.  The  sick 
in  this  field  hospital  which  was  not  rebuilt,  were  sent  to 
another  hospital.  The  field  hospital  which  the  1st  Divi- 
sion left  to  the  3d,  was  in  a  favorable  situation  upon 
the  plain  of  Inkermann.  The  soil  was  dry,  elevated, 
gently  inclined,  and  exposed  to  the  constant  ventilation 
of  a  healthful  breeze.  It  was  an  elongated  quadrilateral, 
divided  into  two  equal  parts  by  a  paved  road,  the 
entrance  guarded  by  a  sentinel,  who  occupied,  some- 
what after  the  manner  of  Diogenes,  a  hut  made  of  two 
butts,  set  one  over  the  other,  and  open  on  the  side.  The 
in  closure  was  formed  by  a  trench,  and  a  pile  of  butts 
filled  with  earth,  served  as  a  parapet.  The  shelters  con- 
sisted of  marquee  tents,  single  or  double,  and  of  Turkish 
tents  or  else  barracks.  Of  the  twenty-four  barracks  seven- 
teen were  provided  by  the  English  at  the  beginning  of  the 
campaign,  but  they  were  not  so  good  as  those  the  army 
subsequently  received.  Low,  damp,  and  badly  venti- 
lated, they  were  used  only  from  necessity.  Those  applied 
to  the  use  of  the  physicians  were  in  the  midst  of  the 
hospital,  where  after  exposure  during  the  day  to  mias- 
matic affections,  they  remained  at  night  still  exposed  to 


THE   CRIMEAN   WAR.  71 

danger.  We  cannot  too  strongly  insist  upon  the  peril 
and  folly  of  such  imprudence.  These  officers  almost 
always  exceed  their  duties,  and  remain  in  the  hospi- 
tals after  their  service  is  finished,  even  refraining  in 
times  of  epidemics  from  taking  horse  exercise,  and 
thus  neglecting  those  preventive  measures  which  they 
recommended  to  others.  This  excess  of  self-denial  de- 
prives the  army  of  competent  men,  and  endangers  the 
attendance  of  the  sick.  There  could  be  nothing  to  pre- 
vent the  officers  of  health  from  lodging  at  least  200 
yards  from  the  hospitals,  leaving  in  them  only  the  medi- 
cal guards  during  the  night. 

It  should  be  remarked  that,  at  times,  the  medical 
staff  was  so  much  pressed  that  human  endurance  and 
the  most  zealous  activity  could  not  supply  the  require- 
ments. However  numerous,  in  time  of  battle  or  of  an 
epidemic,  they  proved  very  inadequate  to  our  wants. 
When  a  half  day's  battle  sends  to  a  hundred  physicians 
in  the  field  hospitals  six  or  seven  thousand  wounded  at 
a  time,  could  they  even  place  so  much  as  a  single  com- 
press and  bandage  upon  each  wound  ?  Much  less  could 
they  perform  upon  each  the  operations  indicated  by 
surgery. 

To  supply  this  want  there  was  created,  in  the  Crimea, 
a  class  of  attendants  of  subordinate  grade,  who  ren- 
dered very  important  services.  Our  system  of  recruit- 
ing makes  our  army  the  vivid  image  of  our  society,  and 
assembles  under  the  flag  its  manifold  elements.  Among 
the  convalescents  Avere  often  found  men  of  education, 
bachelors  of  arts,  and  even  lawyers.  Some  of  these 
returned  to  their  families  on  sick  leave,  but  we  retained 
those  who  appeared  capable  of  assisting  the  physi- 
cians. These  new  duties,  by  employing  their  minds, 
hastened  their  recovery,  and  some,  becoming  fully 
restored,  returned  to  their  corps,  to  be  replaced  by 
others.  These  useful  auxiliaries  are  called  soldier- 
dressers.  Scrive,  Thomas,  and  Lustreman,  in  the  Cri- 
mea and  at  Constantinople,  were  warm  in  their  praises 
of  their  promptitude  and  skill.  When  the  typhus 
decimated  our  medical  corps,  we  feared,  for  a  time, 
that  we  should  be  left  without  physicians,  and  urged. 


72  THE    CRIMEAN   WAR. 

the  Minister  of  War  to  send  some  as  soon  as  possi- 
ble ;  but  he  had  none  at  his  disposal,  and  recruiting 
failed  to  supply  the  want.  Thanks  to  our  soldier- 
dressers,  we  triumphed  over  this  serious  difficulty,  but 
without  them,  our  medical  service  would  have  been 
impeded.  These  subaltern  agents  evinced  a  zeal,  apti- 
tude, and  intelligence,  rarely  witnessed  except  in  the 
French  army.  They  were  intrusted  with  the  care  of  the 
visiting  pass-books,  the  distribution  of  the  food  and  medi- 
cines prescribed,  the  application  of  simple  dressings, 
poultices,  blisters,  and  similar  services.  They  prepared 
with  great  skill  the  splints  for  fractures,  and  even  applied, 
in  a  faultless  manner,  under  the  direction  of  the  chiefs 
of  the  service,  the  dressings  of  amputated  limbs.* 

The  happy  results  gained  by  the  use  of  soldier-dress- 
ers in  the  Crimea,  should  not  be  lost.  It  may  lead 
to  the  total  discontinuance  of  assistant  physicians,  who 
discharge  negligently  duties  they  think  of  too  little 
importance.  Although  they  are  not  doctors,  their 
embroidered  collars  make  them  appear  like  savans,  and 
they  are  too  often  intrusted  with  medical  responsibili- 

*  The  following  note  upon  these  soldier-dressers  is  taken  from  a 
report  of  M.  Lustreman,  chief  physician  of  the  University  Hospital, 
at  Constantinople,  made  January  19,  1856 :  "  Following  the  example 
of  M.  Thomas,  at  Gulhane,  I  have  organized  in  this  hospital  a  little 
company  of  soldier- dressers,  and  can  affirm  that  the  services  rendered 
by  these  men  have  surpassed  my  expectations.  They  have  enabled 
me  to  insure  aid  to  all  the  wounded  at  a  time  when  the  energy  of 
our  medical  force,  whatever  it  may  be,  could  not  fully  supply  the 
want  of  numbers.  Not  only  have  I  met  in  most  of  these  a 
.zeal  worthy  of  all  praise,  but  a  tact  and  facility  in  learning  their 
new  duties,  that  I  had  not  dared  to  count  upon.  One  of  these 
men,  named  Verdun,  whom  I  made  their  chief,  has  twice,  by  a  skil- 
fully applied  compress,  arrested  a  haemorrhage  spouting  from  the 
femoral  artery,  thus  giving  me  time  to  arrive  and  tie  the  vessel.  It 
is  obvious  that  the  field  of  duty  of  these  infirmary  dressers  should  be 
quite  limited,  and  strictly  manual,  and  that  they  should  never  be 
allowed  to  meddle  in  the  scientific,  or  even  the  artistic  departments 
of  the  treatment.  They  are  so  many  hands  added  to  those  of  the 
chief  of  the  service,  and  nothing  more.  This  arrangement,  extempo- 
rized in  the  army  of  the  East,  was  of  great  assistance,  and  appears  to 
me  to  have  given  a  practical  demonstration  of  the  justice  of  the 
views  long  since  expressed  by  Inspector  Baudens,  upon  the  subject  of 
appointing  special  assistants  in  charge  of  the  dressings." 


THE   CRIMEAN    WAR.  73 

ties.*  Taken  from  the  school-benches  to  serve  in  the 
armies,  they  lose  the  best  time  of  life  for  study ;  their 
youthful  years  are  spent  in  the  camps,  and  when  they 
return  they  feel  neither  the  strength  nor  the  courage  to 
recommence  their  classical  studies  to  acquire  the  doc- 
tor's degree.  When  the  medical  faculties  finished  by 
giving  them  a  diploma,  it  was  oftener  on  account  of 
former  services  than  their  scientific  attainments.  Thus 
the  health  corps  of  the  army  has  been  filled  with  very 
inferior  assistants. 

The  English,  besides  their  regimental  infirmaries,  pos- 
sessed four  general  field  hospitals  :  one  at  Inkermann, 
two  at  Balaclava,  and  one  at  the  Monastery  of  Saint 
George.f  Their  medical  service,  directed  by  the  skilful 
and  learned  Sir  John  Hall,  left  nothing  to  be  desired  to 

*  The  embroidered  collars  and  sleeve-cuffs  of  the  coat  distinguish 
the  personnel  of  the  French  service.  They  are  crimson  with  the 
physicians,  and  light  blue  with  the  apothecaries.  There  is  no  dif- 
ference among  the  several  grades,  excepting  that  the  Major  Physi- 
cians of  the  first  class  add  a  wand.  The  auxiliaries  bearing  commis- 
sions from  the  Minister  of  War  have  the  uniforms  of  aides-major, 
but  those  employed  by  military  iutendants  have  no  uniforms. — TR. 

f  The  hospitals  were  known  as  the  General  and  Castle  Hospitals  of 
Balaclava,  the  General  Hospital  of  the  Third  Division,  and  the  Gene- 
ral Hospital  at  Saint  George. 

The  first  of  these  was  of  stone,  and  had  been  used  as  a  Russian 
military  school.  It  consisted  of  two  divisions,  the  front  one  contain- 
ing large,  lofty,  airy  wards,  well  isolated  from  the  ground,  and  the 
other,  of  smaller  apartments,  built  against  the  slope  of  a  hill,  with 
windows  upon  one  side  only.  They  formed  two  sides  of  a  parallelo- 
gram on  the  east  side  of  the  harbor,  the  remaining  sides  being  ranges 
of  buildings  used  as  stores  and  offices.  Besides  these,  there  were 
twelve  or  thirteen  Portland  huts  in  rows  on  the  sloping  ground  above 
the  harbor,  which  were  used  as  wards  for  the  sick.  It  proved  to  be 
on  the  site  of  an  old  graveyard,  and  unhealthy.  It  was  best  suited 
as  a  transit  hospital,  and  latterly  was  almost  entirely  used  for  that 
purpose. 

The  Castle  Hospital  had  a  very  fine  natural  position,  occupying  the 
whole  of  a  long  narrow  ridge  running  nearly  east  and  west,  and  join- 
ing Castle  Rock  with  Marine  Heights.  It  was  three  hundred  and 
twenty  feet  above'  the  level  of  the  sea,  and  cut  off  from  the  adjacent 
higher  ground  by  a  deep  ravine.  The  hospital  consisted  of  a  num- 
ber of  Portsmouth  huts  arranged  side  by  side,  with  the  ends  facing 
the  sea.  Several  other  huts,  on  a  model  called  the  "Chester  hut," 
were  afterwards  erected,  until  the  whole  ridge  was  occupied  by  thirty- 
one  huts,  all,  or  nearly  all,  used  for  hospitals  or  stores.  The  faults  of 


74  THE   CRIMEAN  WAR. 

the  end  of  the  campaign.  The  attendants  discharged 
their  duties  with  zeal,  under  the  impulse  of  active  and 
intelligent  female  hospital  assistants,  at  the  head  of 
whom  was  the  celebrated  Miss  Nightingale.  Beautiful, 
young,  and  wealthy,  she  sacrificed  everything  to  the 
noble  mission  of  alleviating  suffering.  This  delicate 
young  woman,  mounted  on  horseback,  might  be  seen 
passing  from  one  hospital  to  another,  looking  after  the 
sick  of  the  three  allied  armies  with  a  pious  solicitude  ; 
and  at  the  time  of  the  typhus,  she  sent  to  the  French 
and  Sardinian  field  hospitals  a  large  present  of  port 
wine  and  preserves  of  every  kind. 

The  field  hospitals  of  the  English  were  extremely 
clean,  which  cannot  be  said  of  ours.  The  difference 
was  in  part  due  to  the  higher  and  more  independent 
position  of  the  English  military  surgeons,  who  exercise 
more  authority  in  the  enforcement  of  hygienic  mea- 
sures. Their  allowance  of  food  was  better  than  ours. 
Tea,  roast  meat,  and  puddings  held  an  important  place, 

ventilation  that  early  existed  were  afterwards  remedied,  and  the 
results  showed  an  exceedingly  favorable  sanitary  condition. 

The  General  Hospital  of  the  Third  Division,  in  April,  1855,  con- 
sisted of  a  number  of  Portsmouth  huts,  ranged  in  parallel  lines  behind 
the  Third  Division,  and  surrounded  by  the  huts  and  tents  of  several 
regiments.  The  space  was  considerably  raised  above  the  general 
level  of  that  part  of  the  plateau,  and  had  ample  means  of  drainage. 
The  soil  was  a  tenacious  clay,  hardly  capable  of  drainage,  and  liable 
to  become  extremely  muddy  at  every  rain.  The  huts  were  too 
crowded,  their  sides  were  banked  with  earth,  and  the  ventilation  was 
imperfect.  These  huts  were  gradually  appropriated  to  other  uses,  and 
very  few  sick  remained  at  the  close  of  the  year. 

The  General  Hospital  at  Saint  George  was  formed  of  a  square  of 
huts,  similar  to  the  Chester  hut,  upon  a  nearly  level  piece  of  ground 
not  far  from  the  top  of  the  great  ravine,  and  about  five  hundred  feet 
above  the  level  of  the  sea.  The  sides  and  roofs  of  the  huts  were 
double,  and  the  ridge-pieces  were  raised  so  as  to  insure  ventilation 
from  between  the  sides.  Each  hut  was  fastened  down  at  the  angles 
by  timbers,  there  was  a  porch  at  each  end,  and  a  row  of  swing  win- 
dows of  rough  plate  glass  on  either  side.  There  was  one  large  hut 
in  this  hospital  made  of  corrugated  iron,  which,  from  its  conducting 
power  of  heat,  was  found  a  bad  material  for  the  walls  and  roofs.  In 
summer  it  became  overheated,  and  in  winter  too  cold,  thus  exposing 
the  sick  to  injurious  vicissitudes  of  temperature.  The  cases  usually 
sent  to  this  hospital  were  convalescents  and  ophthalmias  from  regiments 
in  the  front. — TR. 


THE   CRIMEAN   WAE.  75 

and  the  physicians  could  order  beer,  wines  of  different 
kinds,  rum,  cognac,  and  whatever  they  judged  proper. 
The  extras  must,  however,  be  prescribed  the  night 
before.  In  the  provision  stores  of  these  hospitals,  I 
have  even  seen  champagne,  which  they  used  to  check 
vomiting. 

The  English  soldier  eats  three  meals  in  the  hospitals, 
the  regimen  of  a  sick  person  being  as  follows : 

For  breakfast,  at  eight  o'clock,  he  received  192 
grammes  (0.42  pounds)  of  bread,  500  grammes  (a  quart) 
of  infusion  of  tea,  made  from  four  grammes  (62 'grains) 
of  the  leaf,  and  24  grammes  (three-fourths  of  an  ounce) 
of  sugar. 

Dinner,  at  noon,  was  composed  of  a  quart  of  broth, 
500  grammes  (1.1  pounds)  of  boiled  or  roasted  meat, 
128  grammes  (four  ounces)  of  bread,  and  500  grammes 
(1.1  pounds)  of  potatoes,  or  other  vegetables.  Of  beer, 
wine,  or  rum,  they  gave  a'variable  quantity,  according 
to  the  medical  prescriptions. 

For  supper,  at  six  o'clock,  they  served  the  same  arti- 
cles as  at  breakfast,  and  in  the  same  quantities.  Broth 
being  given  but  once  a  day  in  the  English  hospitals, 
they  have  the  advantage  of  being  able  to  roast  a  part  of 
the  meat  intended  for  the  pot,  a  practice  very  advan- 
tageous to  the  sick. 

The  Sardinian  field  hospitals  very  much  resembled 
our  own,  and  the  greater  part, of. our  regulations  were 
adopted.  The  medical  service  with  them  is  placed,  as 
with  us,  under  the  authority  of  the  military  intendancy, 
and  is  not  organized,  as  with  the  English,  upon  an  inde- 
pendent basis.  The  learned  physician-in-chief,  M.  Co- 
mizetti,  was  well  seconded  by  able  and  experienced 
practitioners.  Their  field  hospitals  were  located  upon 
the  high  plateaux  of  Kamara,  upon  the  Cape  of  Bala- 
clava, and  were  each  composed  of  42  tine  barracks, 
of  average  capacity  for  36  beds,  planked  and  well 
kept.  The  beds  were  made  of  two  wooden  trestles, 
supporting  three  boards,  upon  which  were  placed  a 
mattress,  a  pillow,  a  pair  of  sheets,  and  two  blankets. 
The  officers  had,  in  addition,  a  straw-bed,  a  bedside  table, 
and  a  mat  spread  down  by  the  side  of  the  bed.  Their 


76  THE   CRIMEAN   WAR. 

regimental  infirmaries  were  arranged  like  ours,  and 
altogether  they  counted  1600  beds,  a  high  number  for 
an  army  of  15,000  or  18,000  men.  Never  more  than 
1200  of  their  beds  were  occupied  at  one  time.  The 
Piedmontese  army  was  heavily  afflicted  with  scurvy, 
but  the  typhus  touched  them  but  lightly.  In  each  sec- 
tion a  Sister  of  Charity  presided  over  the  distribution  of 
food  and  medicines,  supervised  the  attendance  of  the 
sick,  and  directed  the  attendants.  In  the  kitchen,  the 
dispensary,  the  apothecary-room,  the  laundry,  and  the 
wash-room,  was  always  found  a  devoted  and  intelligent 
Sister.  They  went  daily  to  the  market  at  Balaclava,  to 
purchase  provisions ;  and  their  thoughtful  charity  had 
provided  the  field  hospitals  with  a  poultry-yard  of  five 
hundred  hens,  which  were  fed  from  the  refuse  of  the 
table.  The  salary  of  these  Sisters  was  five  hundred 
francs,  and  they  received,  besides,  two  daily  rations  of 
camp  provisions.  They  filled  very  nearly  the  places  of 
our  infirmary-majors.  The  Sardinian  physicians  were 
also  aided  by  soldiers,  in  bleeding,  and  they  also  took 
charge  of  the  prescriptions  and  visiting  pass-books. 
To  each  field  hospital  was  attached  a  skilful  knife- 
grinder — an  excellent  measure,  which  might  be  imitated. 
I  visited  the  Russian  field  hospital  at  Belbec,  which 
was  well  arranged,  and  provided  with  good  furniture. 
They  had  double  beds,  with  separate  mattresses,  sheets, 
and  blankets,  thus  economising  space,  but  not  without 
danger  to  the  sick.  More  than  half  a  century  ago, 
this  unhealthy  practice  was  discontinued  in  France. 
The  barracks,  arranged  for  120  places,  in  four  ranges  of 
beds,  were  well  built,  but  not  ventilated.  In  the  finest 
weather  the  doors  and  windows  were  closely  shut,  the 
air  was  heavy  and  offensive,  and  typhus  made  extensive 
ravages.  My  secretary,  M.  Benjamin  Crombez,  was 
attacked  by  it,  after  remaining  only  a  single  hour  in 
this  field  hospital.  It  is  remarkable  that  the  memory  of 
past  suffering  should  not  prove  more  instructive,  and 
that  the  most  terrible  lessons  should  be  lost.  In  1829, 
their  army  of  the  Danube,  attacked  by  typhus  and  the 
plague,  lost  60,000  men.  The  number  of  men  that 
recrossed  the  Pruth  did  not  exceed  10,000  or  15,000 


THE   CRIMEAN   WAR.  77 

combatants.*  Like  the  English  and  Sardinians,  the 
Russians  employed  women  for  attendants.  To  their 
Sisters  of  Charity,  who  were  much  esteemed,  were 
added  the  lady  attendants,  for  the  most  part  com- 
posed of  officers'  widows,  who  brought  voluntarily 
to  the  Crimea  the  tribute  of  their  pious  devotion. 
They  were  employed  in  the  laundry,  the  kitchen,  and 
the  apothecary-room,  took  care  of  the  wards,  and 
watched  over  the  fever  patients  and  the  wounded,  with 
indefatigable  zeal.  Upon  some  of  the  beds  we  saw 
dead  soldiers,  with  their  faces  uncovered ;  little  wax 
candles  burned  at  the  head  of  the  bed;  doubtless  some 
religious  rite ;  the  adjoining  sick  took  no  notice  of  it. 

Two  Russian  physicians,  taken  prisoners  with  their 
attendants  in  the  attack  on  the  white  works  at  Sebasto- 
pol,  were  brought  to  the  general's  quarters.  One  of  them, 
wounded  in  the  head,  was  taken  care  of  in  the  field  hos- 
pital, while  the  other,  who  was  unhurt,  proved  a  very 
skilful  surgeon,  and  was  placed  in  special  charge  over 
the  wounded  Russians.  Like  the  rest  of  his  country- 
men, he  practised  amputation  by  the  circular  method, 
cut  the  integuments  behind  to  facilitate  the  flow  of  pus, 
and  kept  together  the  lips  of  the  wound  by  a  wick  of 
waxed  lint,  after  the  manner  of  Sedillot,  of  Strasbourg 
— a  practice  which  gave  good  results.  The  Russian 
physicians  spoke  French,  and  lived  with  our  physicians ; 
they  were  afterwards  exchanged  for  some  of  our  men. 
Their  assistants  were  so  skilful  in  ligating  arteries  and 
in  applying  dressings,  that  not  a  single  secondary 
haemorrhage  occurred. 

Felchers  replaced  our  soldier-dressers  in  the  Russian 
army.  They  rank  as  sergeants,  are  a  permanent  class, 
and  are  usually  recruited  from  among  the  orphans  of 
soldiers  dying  in  the  service  of  the  empire.  The 
government  brings  them  up,  and  gives  them  a  crude 
education  in  surgery  and  military  hygiene.  In  the  hos- 
pitals, we  found  one  felcher  to  every  seventy-five  sick  ; 
the  regiments  are  composed  of  four  battalions  of  1000 
men  each,  and  they  have  one  to  a  battalion.  The  sur- 

*  "  Campagnes  des  Russes  dans  la  Turquie  d'Europe,  en  1828  et 
1829,"  by  Colonel  Baron  de  Moltke. 


78  THE    CRIMEAN   WAR. 

geons  under  whose  orders  the  felchers  are  placed,  praised 
very  highly  their  behavior,  intelligence,  and  subordi- 
nation. 

As  to  the  physicians  of  the  Russian  army,  they  are 
either  the  orphans  of  officers,  brought  up  and  educated 
at  the  expense  of  the  government,  or  physicians  taken 
from  the  ranks  of  the  profession,  and  graduated  from 
their  great  universities.  The  state  requires  of  the  for- 
mer six  years'  active  service ;  the  latter  can  resign. 
After  having  served  twenty-five  years,  they  may  both 
claim  a  retiring  pension,  which  equals  half  their  pay 
according  to  rank.  After  thirty  years'  service  the 
pension  is  the  same  as  if  in  active  service.  Every  five 
years  after  the  first  six,  they  receive  an  increase  of 
pay.  Like  the  officers  of  the  army,  their  grades  begin 
with  the  rank  of  captain,  and  rise  to  that  of  general, 
sharing  with  the  other  officers  all  military  honors,  as 
well  as  dangers  and  privations.  The  Russian  soldiers 
carry  in  their  knapsacks  a  compress  and  roll  of  bandage — 
precious  resources,  which  allow  of  the  instant  and  effi- 
cient application  of  a  first  dressing  upon  the  battle-field, 
where  articles  for  dressings  are  so  often  wanting. 


CHAPTER   II. 
SURGICAL    OPERATIONS. 

MOST  of  the  surgical  operations  are  made  in  the  field 
hospitals,  and  consist  of  extraction  of  balls,  amputations, 
and  resections. 

In  the  Crimean  campaign,  the  severity  of  the  wounds 
was  not  only  due  to  bullets  and  shell,  so  terrible 
in  a  siege,  but  also  to  the  employment  of  arms  of 
precision,  and  the  substitution  of  conical  balls  for 
round.  These  improvements  were  known  to  the  Rus- 
sians, and  were,  before  the  walls  of  Sebastopol,  as  mur- 
derous to  the  besiegers  as  to  the  besieged.  But  still, 
thanks  to  the  genius  of  our  nation,  to  the  intelligence, 


THE   CRIMEAN   WAR.  79 

activity,  and  hardihood  of  our  soldiers — these  arms 
"essentially  French,"  as  Marshal  Bugeaud  says,  were 
peculiarly  destructive  in  their  hands. 

The  arrow  had  for  some  time  suggested  the  idea  of 
giving  to  spherical  projectiles  an  elongated  form,  in 
order  to  diminish  the  resistance  of  the  air. 

It  has  been  long  attempted  to  substitute  for  the 
smooth  bore,  tubes  grooved  in  spiral  form,  which  should 
give  to  the  ball  a  rotary  motion  ;  this  idea  is  the  sequel 
of  the  preceding  one.  This  rotative  motion  can  only  be 
gained  by  forcing  the  ball  into  the  groove,  and  to 
remedy  the  inconvenience  of  driving  it  in  with  the  blows 
of  a  mallet,  the  flattening  method  has  been  proposed, 
especially  by  M.  Delvigne.  This  is  done  by  driving  the 
leaden  ball  smartly  with  the  ramrod,  against  a  little  pro- 
jection in  the  chamber  of  the  gun.  In  the  forcing  by 
dilatation  afterwards  proposed,  the  cylindro-conical  balls 
are  hollowed  at  their  base,  and  the  gases  resulting  from, 
the  ignition  of  the  powder,  act  upon  this  concave  sur- 
face by  a  violent  expansive  effort,  forcing  the  lead  into 
the  furrows  of  the  barrel.  The  former  system  has  been 
in  use  in  France  more  than  twenty  years,  but  the  second 
only  a  few,  and  has  likewise  been  adopted  in  England. 
Experience  having  shown,  that  after  passing  a  certain 
distance,  the  longer  axis  of  the  projectile  tends  to  incline 
from  the  line  of  flight,  this  has  been  remedied  by  the 
ingenious  and  simple  use  of  circular  grooves,  made 
around  the  ball  near  its  base,  which  perform  the  office 
of  quills,  or  plumes,  which,  in  the  flight  of  an  arrow, 
are  so  important.* 

Arms  of  precision  have  received  new  improvements, 
known  by  the  names  of  their  inventors,  Poncharra, 
Minie,  and  Thouvenin,  and  to  the  latter  belongs  the  honor, 
of  having  produced  the  carbine  called  d  tige,  so  much 
esteemed  among  the  battalions  of  foot  chasseurs.  The 
tige  is  a  little  cylinder  of  steel,  screwed  into  the  middle 

*  The  Russian  rifle  was  little  inferior  to  the  minie  in  range  or  force, 
while  its  conical  deep  cupped  ball  was  heavier.  The  severity  of  the 
primary  action  on  the  part  struck,  and  the  aggravated  evils  which 
followed  their  wounds,  combined  to  exercise  a  most  prejudicial  influ- 
ence on  the  surgery  of  the  war. — TR. 


80  THE   CRIMEAN   WAR. 

of  the  breech,  and  of  less  diameter  than  the  barrel.  The 
powder  lies  around  the  tige,  and  the  expansion  of  the 
ball  is  effected  by  flattening  it  against  the  top.*  The 
range  of  these  balls  is  more  than  1,400  yards,  but  beyond 
800  yards  it  is  not  exact.  Experiments  have  shown,  that 
a  round  ball,  at  a  range  of  600  yards,  will  not  pass  through 
two-inch  fir  planks,  while  a  cylindro-conical  ball,  thrown 
from  this  carbine,  will  easily  perforate  eight  such  planks. 

Wounds  present  different  characters,  according  to  the 
velocity  and  shape  of  the  projectile.  The  hole  where  a 
spherical  ball  has  entered,  is  round,  depressed,  and  smaller 
than  that  where  it  comes  out.  The  path  which  it  traces 
through  the  limb,  is  conical,  and  goes  on  enlarging,  and 
if  it  meets  the  sheath  of  a  tendon,  or  a  bony  surface,  it 
is  often  much  deflected  from  its  course,  so  that  it  is  not 
rare  to  find  the  place  of  outlet,  which  is  more  irregular 
and  bruised,  with  the  lips  raised  and  jutting  not  directly 
opposite  the  entrance.f 

The  place  of  entrance  of  a  cylindro-conical  ball  is 
oval,  and  sometimes  linear,  as  if  made  with  the  point  of 

*  This  arm  was  furnished  to  the  Chasseurs  de  Vincennes.  The  ball 
weighed  1  ounce  5  drachms  and  16  grains. — Tr. 

f  It  is  not  always  easy  to  distinguish  the  gunshot  wound  of  en- 
trance from  that  of  exit.  According  to  Dr.  Macleod  the  former  is 
more  regular,  and  less  discolored  than  the  latter.  The  inversion  of  the 
lips  of  the  wound  in  one  case,  and  their  eversion  in  the  other,  is  not 
always  clearly  marked,  and  if  the  velocity  of  the  ball  has  been  great, 
and  no  bone  has  been  struck,  there  is  very  little  difference  in  either 
the  size  or  discoloration  of  the  wounds.  The  enlargement  of  the 
wound,  as  the  projectile  enters,  is  common  when  the  velocity  is  nearly 
spent,  or  when  a  bone  or  aponeurosis  has  checked  the  force,  and 
changed  the  direction  of  the  ball.  This  is  especially  true  of  the  coni- 
cal projectiles.  Muscular  wounds  from  gunshot,  almost  always  heal 
by  suppuration  and  granulation,  the  exceptions  being  extremely  rare. 
The  opening  of  a  wound  may  be  apparently  smaller  than  the  projec- 
tile. At  Scutari,  a  piece  of  shell  weighing  nearly  three  pounds,  was 
extracted  from  the  hip  of  a  man  wounded  at  Alma,  which  had  been 
overlooked  two  months,  and  entered  by  a  small  aperture.  Larrey 
gives  a  case  of  a  ball  weighing  five  pounds,  which  was  extracted 
from  the  thigh  of  a  soldier.  It  had  not  been  detected  by  the  surgeon 
making  the  dressing,  and  incommoded  only  from  the  weight.  Frag- 
ments of  nine  and  twelve  pounds  weight  have  been  reported  as  buried 
in  the  thigh  with  no  suspicion  for  a  time  of  their  presence.  The  elas- 
ticity of  the  soft  parts  enables  us  to  explain  the  smallness  of  the 
entrance  wounds  in  these  cases. — Tr. 


THE   CRIMEAN   WAR.  81 

a  sabre;  the  ball  which  General  Thomas  received  in 
the  groin  at  Alma  made  a  wound  exactly  like  that  of  a 
sword  or  bayonet.  Their  line  of  passage  does  not  ap- 
pear to  take  the  form  of  an  elongated  cone,  which  is 
probably  owing  to  its  twisting  motion,  and  deviates 
much  less  from  its  course,  than  the  round  ball.  Neither 
the  sheaths  of  muscles,  nor  tendons,  nor  bones  resist 
the  penetrating  points  of  conical  projectiles,  the  lead  is 
perhaps  battered  or  turned,  so  as  to  present  its  greatest 
surface,  which  is  about  a  third  of  an  inch  in  area.  In 
this  case  the  outlet,  which  does  not  usually  differ  from 
the  entrance  wound,  except  that  it  is  larger,  and  with 
its  lips  more  bruised  and  projecting,  presents  unusual 
dimensions  with  rags  of  flesh  very  irregularly  torn. 

If  a  round  ball  meets  at  an  inclined  angle,  a  curved 
bone,  as  the  cranium  or  a  rib,  or  a  long  round  bone  as 
the  femur,  it  often  passes  around,  instead  of  breaking 
it,  but  a  conical  shot  almost  always  breaks  It  into  splin- 
ters. We  therefore  observed  in  the  Crimea  a  propor- 
tionally larger  number  of  fractures  from  balls  than  in 
our  African  wars.  It  should  nevertheless  be  remem- 
bered, that  a  round  ball  scarcely  weighs  an  ounce,  while 
the  others  are  nearly  twice  as  heavy.  When  a  conical 
ball  strikes,  it  may  perhaps  be  inclined,  so  as  to  enter 
crosswise.  In  such  cases,  which  are  rare,  the  entrance 
and  path  are  very  large  ;  we  usually  find  the  lead  at  no 
great  depth.  Its  extraction  is  easy. 

In  1830,  when  I  joined  the  army  sent  to  Algeria,  it 
was  the  rule  and  practice  to  lay  open  with  a  bistoury 
the  holes  of  entrance  and  exit  made  by  balls.  The 
most  approved  teachers  advised  large  incisions  of  the 
skin  and  subjacent  tissues,  to  favor  granulations  in  the 
injured  parts,  and  prevent  their  choking  up,  thus  avoid- 
ing the  evils  which  ensue  from  such  cases,  as  for  exam- 
ple gangrene.  This  bloody  operation,  called  unloosen- 
ing, was  much  more  painful  than  the  wound  made  by 
the  ball,  but  no  one  questioned  its  efficacy.  It  had  be- 
come, so  to  speak,  a  medical  dogma.  In  the  early 
conflicts  in  Africa,  at  Sidi-Ferruck  and  Staoueli,  I 
saw  with  astonishment  a  large  number  of  wounds, 
which,  for  want  of  time,  had  not  been  enlarged  with  a 

5 


82  THE    CRIMEAN   WAK. 

cutting  instrument,  healed  without  mishap,  and  even 
more  quickly  than  those  through  which  the  bistoury 
had  passed.  In  the  Crimea,  I  observed  with  satisfaction, 
that  the  unloosening  of  wounds  had  not  a  single  partisan. 
Although  it  still  finds  academic  partisans,  it  has  been 
styled  a  useless  and  barbarous  practice.  In  these  terms 
I  spoke  of  it  in  a  work  published  in  1836,*  and  nothing 
has  occurred  to  lead  me  to  change  my  opinion.  I  have 
even  proved,  that  free  openings  do  not  prevent  acci- 
dents, when  the  wound  contains  foreign  bodies,  as 
wadding,  pieces  of  clothing,  or  lint,  drawn  in  by  the 
projectile,  or  when  the  ball  itself,  whether  entire  or 
broken,  has  come  in  contact  with  bone,  breaking  it  into 
splinters. 

Sometimes  these  splinters  of  bone  remain  in  the 
flesh,  irritating  it  like  thorns,  in  which  case  the  best 
remedy  is,  to  extract  these  foreign  bodies.  Should 
we  trust  to  the  eliminating  agency  of  suppuration, 
as  is  still  advised,  in  getting  rid  of  these  splinters  ? 
Failures  in  this  are  so  common,  that  it  is  evidently 
preferable  to  take  them  all  out  as  soon  as  possible, 
whether  adherent  or  not,  with  the  view  of  simplifying 
the  wound.  A  simple  wound  heals  regularly,  without  in- 
ducing a  variety  of  painful  complications,  which  every 
moment  endanger  the  lives  of  the  wounded.  Lisfranc 
said,  we  should  wage  a  partisan  warfare  with  these 
complications,  that  is  that  we  should  combat  them  bis- 
toury in  hand.  It  would  be  better  still,  to  prevent 
them,  by  removing  the  splinters  at  once.  Their  reten- 
tion leads  to  endless  suppurations,  with  constant  suf- 
fering, which  is  increased  whenever  a  piece  of  bone 
works  out,  thus  wasting  away  the  vital  forces,  causing 
marasmus,  reabsorption  of  pus,  colliquative  diarrhoea, 
and  death. 

On  the  contrary,  when  the  wound  contains  not  a 
bony  splinter,  but  a  round  smooth  ball,  of  which  the 
surgeon  cannot  readily  find  the  track,  it  is  wiser  not 
to  multiply  his  searches,  and  to  spare  sufferings  to  his 

*  Olinique  des  Plaies  tfArmes  dfeu,  1  vol.  8vo.  Paris.  1836.  J.  B. 
Bailliere. 


THE   CRIMEAN   WAK.  83 

patient,  as  its  presence  is  less  irritating  than  the  angles 
of  a  splinter,  and  furthermore,  in  the  course  of  healing, 
the  ball  will  work  towards  the  surface,  and  will  be 
more  easy  to  reach. 

The  extraction  of  balls  is  often  a  difficult  operation, 
because  they  traverse  tissues  of  various  density,  and 
therefore  of  different  degrees  of  resistance,  which  cause 
them  to  deviate  from  a  direct  line.  A  ball  striking  a  rib 
obliquely,  does  not  always  penetrate  the  chest,  but  passes 
along  the  curve  of  the  bone,  upon  which  it  is  held  by 
the  elasticity  of  the  skin,  neutralising  its  centrifugal 
force.  When  a  ball  penetrates  the  tissues,  it  tears 
them  by  pushing  forward,  like  a  blunt  point ;  and  at  the 
end  of  its  course,  it  often  meets  in  the  skin  a  resistance 
which  it  cannot  overcome,  and  it  remains  just  beneath 
the  surface.  In  this  case,  by  taking  it  between  the 
thumb  and  fore  finger  of  the  left  hand,  and  cutting  the 
skin  over  it,  with  a  little  gentle  pressure  down  and 
behind,  it  will  roll  out.  If  it  resists,  it  is  needless  to 
enlarge  the  incision,  and  we  must  ascertain  what 
holds  it.  The  obstacle  may  be  due  to  a  thin  and  trans- 
parent layer  of  cellular  tissue,  with  which  the  projectile 
has  enveloped  itself  in  its  thrusting  course  at  the  end  of 
its  flight.  It  forms  a  little  sac,  which  only  needs  to  be 
opened  to  allow  the  ball  to  escape. 

I  can  demonstrate  this  fact  conclusively,  and  have 
called  this  the  primitive  sac,  to  distinguish  it  from 
the  definitive  sac,  organized  around  balls  when  left 
to  themselves,  and  allowed  to  remain,  thus  becoming 
naturalised  in  the  tissues.*  These  singular  guests  may 
ever  after  remain  quite  harmlessly  in  their  sacs,  or  at 
times,  the  pressure  caused  by  the  weight  of  the  lead 
may  irritate  and  soften  the  sac ;  the  bull  opens  for  it- 
self a  path  step  by  step,  the  void  behind  closes 
gradually  by  granulation,  a  process  of  cicatrization 

*  This  observation  has  not  been  made  by  other  writers  upon 
Military  Surgery,  and  the  cellular  envelope,  although  occasionally 
found,  is  rare. 

Muscles  wounded  by  gun-shot  are  apt  to  shorten  during  the  cure, 
unless  care  is  taken  to  prevent  it.  The  result  is  always  unfortunate. 
— TR. 


84  THE   CRIMEAN    WAR. 

which  presses  it  forward  upon  its  journey.  The  pro- 
gress is  slow  and  almost  imperceptible,  so  that  only 
in  the  course  of  years  will  a  bail  which  was  in  the 
groin,  descend  to  the  heel. 

Wounds  made  by  fire-arms,  being  essentially  contus- 
ed, cause  a  strong  inflammatory  reaction,  which,  by  a 
variety  of  accidents,  may  lead  to  gangrene,  and  demand 
oftentimes  an  energetic  treatment.  In  these  wounds, 
the  best  therapeutic  agent  I  have  found  to  be  cold,  pro- 
duced by  ice.  The  illustrious  Percy  used  cold  water, 
in  treating  gunshot  wounds.  I  have  followed  his 
example  with  results  so  favorable,  that  I  was  led  to 
study  carefully  the  action  of  refrigerants.  When  the 
inflammation  exceeds  certain  limits,  cold  water  is  not 
sufficient,  and  we  must  then  resort  to  ice,  either  alone, 
or  mixed  with  sea-salt,  to  increase  the  intensity  of  the 
cold,  which  should  be  regulated  according  to  the  vio- 
lence of  the  traumatic  inflammation.  Ice  should  never 
be  in  direct  contact  with  the  surface.  We  begin 
by  placing  upon  the  inflamed  part  a  simple  compress 
of  linen,  soaked  from  time  to  time  in  cold  water,  and 
then  put  pieces  of  ice  in  the  folds.  If  the  refrigera- 
tion does  not  procure  more  than  a  moderate  relief  with- 
out destroying  the  deep  and  painful  sense  of  heat,  or,  as 
the  patients  express  it,  if  the  ice  seem  to  burn,  the 
cold  should  be  increased,  by  the  addition  of  salt.  No- 
thing is  easier  than  to  avoid  the  abuse  of  refrigerants, 
and  the  accidents  resulting  from  their  use.  The  con- 
tact of  cold  upon  an  inflamed  part  causes  an  agree- 
able and  decided  sense  of  relief,  and  this  is  an  infallible 
guide,  which  should  be  carefully  observed.  The  refri- 
gerants should  be  continued,  so  long  as  they  produce 
this  sensation,  and  should  be  gradually  withdrawn 
when  they  cause  a  disagreeable  sensation  of  cold  damp- 
ness. This  does  not  occur  until  the  fire  of  inflamma- 
tion is  extinct ;  and  if  continued,  the  ice  would  cause 
the  most  severe  pain,  from  the  abstraction  of  the  nor- 
mal amount  of  caloric.  The  patient  is  therefore  the 
best  judge  to  consult.  Before  applying  ice,  the  physi- 
cian should  ascertain  the  general  condition  of  the 
patient.  If  the  constitution  has  been  enfeebled  by 


THE    CRIMEAN    WAE.  85 

fatigues  and  privations,  if  he  fears  that  the  broken  vital 
energies  will  fail,  and  that  a  salutary  reaction  Avill  not 
ensue,  he  will  give  stimulant  drinks  instead  of  refrige- 
rants, and  place  over  the  wound  a  thick  layer  of  lint, 
to  retain  the  heat.  The  use  of  ice,  in  such  a  case,  would 
be  a  monstrous  absurdity. 

The  opponents  of  the  refrigerating  treatment  appre- 
hend gangrene,  or  at  least  the  reaction  and  check  of 
perspirations.  It  is  difficult  to  understand  d  priori  how 
a  limb  can  without  danger  be  covered  with  ice  several 
days  at  a  time,  when  a  single  icicle  held  a  few  moments 
in  the  fingers,  leads  to  a  beginning  of  congelation, 
keen  pain,  and  a  feeling  of  insupportable  constriction. 
It  is  because  in  the  one  case  the  ice  acts  upon  an  inflamed 
surface,  and  in  the  others  upon  a  healthy  part.  Inflam- 
mation imparts  to  the  region  of  which  it  is  the  seat,  a 
remarkable  power  of  resisting  cold.  Hunter,  after 
having  frozen  the  ear  of  a  rabbit,  by  immersing  it  in 
a  dish  of  pounded  ice,  could  not  freeze  it  again,  when 
inflammation  had  set  in.  This  was  a  great  discovery. 
The  organic,  normal,  or  physiological  heat,  existing  in 
health,  should  be  distinguished  from  the  abnormal  heat 
of  inflammation.  The  former  is  indispensable  in  regu- 
lating the  animal  functions,  and  cannot  be  withdrawn 
without  peril ;  we  know  that  a  simple  chill  may  be 
dangerous.  The  caloric  produced  from  inflammation, 
if  it  does  not  exceed  a  certain  degree  necessary  for 
healthy  action,  ought  not  to  be  lessened.  It  is  when  it 
appears  in  excess  that  it  is  full  of  danger,  and  excites  a 
host  of  disastrous  results.  It  is  better  in  these  cases  to 
resort  to  refrigerant  applications,  than  to  local  or  general 
bleeding.  Cold  is  a  sedative,  calming  the  pain,  and 
preventing  the  determination  of  blood  to  the  affected 
part,  while  bleeding,  by  suction,  and  the  painful  prick- 
ing, attracts  the  blood,  and  congests  the  wound.  Cold 
acts  upon  the  patient  as  a  tonic,  while  bleeding  weakens ; 
cold  is  a  most  energetic  agent  for  arresting  inflamma- 
tion and  preventing  it  from  spreading,  while  bleeding  is 
often  powerless ;  and  cold  tends  to  localize  the  phlegma- 
sia,  imprison  it  in  the  wound,  and  prevents  its  sympa- 
thetic transmission  to  the  great  viscera,  especially  the 


86  THE   CRIMEAN  WAR. 

heart,  the  reaction  on  which  excites  fever.  The  inflam- 
mation has  sometimes  been  so  intense,  that  I  have  had 
to  apply  for  several  days,  to  complicated  wounds  that 
were  choked  up,  a  freezing  mixture  of — 14°  Centigrade 
(  — 4°  Fahrenheit). 

During  the  insurrection  of  1848,  I  kept  ice  during 
forty  days  upon  the  leg  of  a  wounded  officer.  A 
quarter  of  the  substance  of  the  tibia,  ground  to  pieces 
by  the  projectile,  had  been  extracted  to  simplify  the 
wound ;  an  amputation  was  avoided,  and  fifteen  months 
after,  this  officer  laid  aside  his  crutches,  and  could  walk 
freely.  This  was  one  of  the  finest  triumphs  of  conserva- 
tive surgery. 

Treatment  by  ice  may  not  only  be  applied  to  wounds 
received  in  war,  but  also  to  lesions  resulting  from  acci- 
dents, as  dislocations,  contusions,  and  fractures,  and 
especially  to  strangulated  hernia,  which  it  relieves  with- 
out an  operation,  with  great  success.*  It  is  proper  to 
limit  its  use  to  lesions  caused  by  violence,  because  the 
inflammatory  action  is  then  decided,  simple,  and  free 
from  predisposing  individual  influences.  Used  on  a 
multitude  of  patients  at  Val-de-Grace,  where  I  directed 
the  surgical  service  during  ten  years,  the  treatment  by 
ice  has  been  tested;  military  surgery  has  adopted  it 
and  finds  it  answer. 

When  a  splinter  of  a  shell  strikes  by  one  of  its  angles, 
it  makes  a  large  cut,  very  clean  in  appearance,  but  one 
which  cannot  heal  until  after  the  adjacent  parts,  that 
have  been  killed  by  the  violence  of  the  shock,  are  elimi- 
nated. These  wounds  had  in  the  Crimea  a  remarkable 
tendency  to  the  characteristics  of  hospital  gangrene. 

"When  cannon  balls  nearly  spent  are  rolling  upon  the 
ground,  they  must  be  carefully  avoided,  even  when  the 
motion  is  very  slow.  A  grenadier  of  the  guard,  lying 
upon  his  side  on  the  ground,  was  suddenly  killed  by  a 
ball  which  broke  his  spinal  column.  This  ball  had  so 
little  force  left,  that  by  a  singular  coincidence  it  lodged 
in  the  hood  of  the  soldier,  and  was  found  there. 

*  On  the  29th  of  May,  1854, 1  read  before  the  Academy  of  Sciences 
a  memoir  upon  the  value  of  ice  in  the  reduction  of  strangulated 
hernias. 


THE  CRIMEAN  WAR.  87 

Bombs  always  produce  very  serious  wounds,  and  make 
in  the  chest  and  abdomen  such  terrible  breaches,  that 
art  is  powerless  for  relief.  When  a  ball,  or  a  piece  of  a 
bomb,  has  taken  off  a  limb,  the  wounded  man  very 
often  evinces  the  effects  of  a  general  shock,  and,  as  soon 
as  the  stupor  begins  to  pass  off,  the  hand  of  the  surgeon 
is  necessary,  to  trim  the  wound.  If  left  to  the  un- 
aided efforts  of  nature,  the  violently  torn  tatters,  mixed 
with  tendinous  portions  of  unequal  length,  and  bruised 
pieces  of  bone,  almost  invariably  tend  to  a  mortal  gan- 
grene. The  rupture  of  arteries  may  cause  haemorrhages 

that  prove  quickly  fatal.      General  R died  in  a 

few  moments  from  a  haemorrhage  caused  by  a  musket 
ball,  which  divided  the  popliteal  artery.  His  life  might 
have  been  saved  by  compressing  the  vessel  until  a  sur- 
geon arrived.  There  are  some  cases  in  which  the  vio- 
lence of  the  blow  itself  brings  with  it  an  effectual 
remedy ;  the  tearing  off  of  a  limb  leads  to  a  retrac- 
tion of  the  arterial  tissues,  and  the  opening  of  the  tube 
closes  upon  itself,  thus  opposing  a  barrier  to  the  expul- 
sion of  the  blood. 

Sometimes  the  effects  of  bombs  are  horribly  fantastic. 
General  Pecqueux  de  Lavarande  was  literally  cut  in  two 
by  a  bomb  which  exploded  between  his  legs,  the  head 
remaining  on  one  side  with  an  arm  and  a  leg.  Other 
effects  more  singular,  but  not  as  horrible,  were  many 
times  observed  during  the  siege  of  Sebastopol.  We 
know  that  bombs,  in  traversing  their  parabolic  curve, 
give  out  a  peculiar  hissing  sound,  which  enables  one  to 
dodge  them,  and  by  dropping  flat  upon  the  ground,  to 
avoid  the  explosion.  It  has  so  happened,  that  at  the 
instant  when  the  soldiers  are  stooping  to  drop  on  the 
ground,  the  bomb  in  its  path  followed  the  curvature  of 
the  spinal  column,  and  crushed  it  the  whole  length,  caus- 
ing instant  death.  At  another  time,  when  the  shock 
was  less  violent,  the  spinal  column  resisted,  the  skin  from 
its  elasticity  was  not  broken,  and  the  subcutaneous 
bloodvessels  were  alone  torn.  In  this  instance,  the 
blood  accumulated  near  the  os  sacrum,  at  its  lowest  part, 
and  the  sac  was  punctured  by  the  subcutaneous  method 
of  M.  G.  Guerin,  to  avoid  danger  from  the  introduction 


88  THE   CRIMEAN   WAR. 

of  air  into  the  closed  cavities.     A  black  gr unions  blood 
escaped,  and  the  patient  recovered. 

At  another  time,  we  found  on  the  battle-field  a  dead 
body  which  showed  no  external  marks  of  wound,  and 
whose  death  they  ascribed  to  the  wind  of  the  ball. 
This  is  now  acknowledged  to  be  an  error,  for  we  have 
seen  a  ball  take  off  a  knapsack  from  a  soldier's  shoulders, 
his  cap,  and  even  his  pipe,  without  leaving  any  effect  of 
its  passage ;  and,  again,  the  parts  under  the  skin  have 
often  been  found  bruised  to  pulp,  and  the  bones  broken 
to  atoms.  The  wind  of  a  ball  could  not  do  such 
damages,  but  it  was  the  ball  itself,  especially  in  some 
of  its  last  rebounds,  towards  the  end  of  its  flight. 
The  elasticity  of  the  skin  explains  why  it  can  remain 
nnkroken,  although  a  ball  may  come  in  contact  with 
the  body. 

At  the  battle  of  the  Alma,  the  splinter  of  a  shell  struck 
General  Canrobert  on  the  breast,  bruising  the  pectoral 
muscle,  while  it  scarcely  broke  the  skin.  General  Bos- 
quet received  on  the  after  part  of  his  chest  just  below 
the  shoulder  blade,  a  splinter  of  a  shell.  The  skin  became 
ecchymosed,  but  was  not  broken,  although  three  ribs 
were  fractured  on  their  inner  side,  in  a  curved  form ;  they 
were  replaced  with  difficulty,  and  left  a  very  apparent 
depression,  which  was  quite  perceptible  to  the  touch. 
This  fracture,  probably  complicated  with  a  rupture  of  the 
lung,  admitted  into  the  chest  an  effusion  of  blood  which 
crowded  the  pulmonary  tissue  against  the  spinal  column, 
and  hindered  the  introduction  of  air  into  the  bronchial 
cells.  The  general  was  very  skilfully  treated  by  M. 
Secourgeon,  chief  physician  of  the  3d  Corps,  and  by 
Dr.  Cornbarieu,  who  had  him  carried  from  the  trenches 
to  the  Lancaster  batteries,  where  he  was  bled.  M.  Com- 
barieu  then  took  him  to  Pan,  to  the  house  of  his  aged 
mother. 

The  department  of  our  science  which  treats  of  ampu- 
tation is  of  first  importance.  When  ought  wre  to  prac- 
tise it,  and  when  avoid  it  ?  Upon  these  t\vo  questions 
the  Crimean  war  has  shed  a  flood  of  precious  light. 
During  the  wars  of  the  empire,  no  matter  in  what  part 
of  the  leg  the  wound  wras  situated,  were  it  even  the 


THE    CRIMEAN   WAE.  89 

heel,  they  practised  amputation  at  about  four  or  five 
fingers'  breadth  below  the  knee.  The  stump,  disguised 
by  a  long  pantaloon,  was  fastened  to  a  wooden  leg  of  the 
simplest  kind  and  not  liable  to  get  out  of  order. 

There  was  here  an  advantage  which  many  surgeons  do 
not  like  to  give  up.  During  the  last  twenty  years  however 
distinguished  practitioners  have  laid  down  the  precept, 
that  the  amputation  should  be  made  as  low  as  possible, 
and  always  just  above  the  ancles,  that  is,  the  ankle  bones. 
At  this  point  the  leg  is  smaller  than  above,  the  wounded 
surface  is  less,  there  is  less  inflammation,  ulterior  acci- 
dents are  reduced,  and  cases  of  healing  are  numerous. 
This  rule  involves  the  general  principle,  that  we  should 
always  amputate  as  far  from  the  trunk  as  possible.  The 
office  of  the  surgeon  is,  above  all,  to  save  the  life  of  the 
wounded,  and  his  conscience  bids  him  prefer  the  safest 
way.  Other  reasons  operate  in  favor  of  the  sub-malleolar 
amputation.  The  important  articulation  of  the  knee  is 
preserved,  and  by  the  aid  of  an  artificial  limb  it  is  easy 
to  conceal  the  mutilation.  This  consideration  is  not  one 
of  indifference  to  a  young  man  who  has  his  way  to  make, 
nor  even  to  a  superior  officer,  commanding  on  horseback. 
A  lieutenant-colonel  upon  whom  I  performed  the  opera- 
tion was  able  to  continue  in  the  service,  and  is  now  a 
colonel.  It  is  true  that  the  apparatus  furnished  to  the 
soldier  who  has  suffered  an  amputation  above  the  ancle 
bones  costs  two  or  three  times  as  much  as  the  classic 
peg,  but  the  State  will  never  be  run  in  debt  by  so  small 
an  affair.  I  demonstrated  in  1839,*  that  we  may  take 
off  the  whole  foot  without  having  recourse  to  amputation 
of  the  leg,  taking  a  flap  from  the  soft  parts  to  cover  the 
wound  on  the  instep,  or  better  still,  on  the  heel.f  In  the 
Litter  case  the  amputated  person  walked  well  without  the 
aid  of  any  apparatus,  by  bearing  the  weight  of  the  body 
upon  a  short  wooden  leg  fixed  to  a  bootee  with  a  high 
heel.  I  have  met  some  amputations  performed  in  the 
middle  of  the  calf  of  the  leg,  and  I  have  blamed  them 

*  New  method  of  amputations,  first  memoir,  Tibio-Tarsal  Amputa- 
tion.— Paris,  Germer-Bailliere,  1842. 

f  Nouveau  precede  de  I'amputation  tibio-tarsienne,  with  a  Plate. — 
Gazette  des  Hopitaux,  Feb.  1850. 


90  THE   CRIMEAN   WAR. 

exceedingly.  Soldiers  should  never  be  subjected  to  such 
experiments,  and  the  army  council  of  health  are  quite 
right  in  maintaining  the  wise  and  traditional  rule,  which 
prohibits  military  surgeons  from  employing  modes  of 
treatment  and  operations  not,  sanctioned  by  experience. 
An  amputation  in  the  middle  of  the  calf  has  serious  in- 
conveniences. The  volume  of  the  leg,  much  greater  at 
this  place,  gives  a  large  wound  and  increases  the  chances 
of  mortality.  The  stump  is  left  too  long,  so  that  a 
wooden  leg  cannot  be  readily  applied. 

A  truth,  which  numerous  tacts  observed  in  the  Crimea 
now  allow  me  to  affirm,  is — that  when  it  is  not  possible 
to  amputate  the  leg,  the  disarticulation  of  the  knee  is 
to  be  preferred  to  the  amputation  of  the  thigh.  The 
former  succeeds  oftener  than  the  latter.  The  disarticu- 
lation of  the  knee  should  be  done  immediately  ;  and  it  is 
a  point  acquired  henceforth  for  science,  that  we  hazard 
success  by  delay.  In  fact  the  volume  of  bone,  even  in  a 
state  of  health,  is  not  in  harmony  with  that  of  the  soft 
parts,  and  the  disproportion  will  become  greater  as  the 
patient  loses  flesh  by  prolonged  suffering  and  profuse 
suppuration.  This  amputation  preserves  to  the  patient 
the  free  use  of  the  hip-joint,  and  gives  a  solid  point  of 
attachment  for  an  artificial  limb. 

For  half  a  century  surgeons  have  discussed  the 
question,  whether  it  is  better  to  perform  an  amputation 
as  soon  as  possible,  or  to  wait  some  days,  if  not  weeks. 
At  the  present  day  the  first  of  these  two  opinions  has 
decidedly  the  preference,  and  the  results  of  observations 
in  the  East  militate  in  its  favor.  We  shall  observe,  for 
example,  in  a  review  of  immediate  and  delayed  amputa- 
tions practised  in  the  hospital  at  Gulhane,*  that  three 
immediate  tibio-femoral  amputations  succeeded,  and 
that  five  consecutive  amputations  performed  after  some 
delay  at  Constantinople,  failed. 

Before  the  Crimean  war  it  was  a  generally  received 
rule,  that  a  femoral  fracture  by  fire-arms  rendered  an 
amputation  necessary.  There  is  reason  to  believe  that, 
thanks  to  my  new  apparatus  for  fractures,  this  rule  may 

*  3ee  Appendix. 


THE   CRIMEAN   WAR.  91 

be  considered  too  absolute.*  These  appliances  have  the 
advantage  of  keeping  the  limb  in  its  normal  position  with- 
out compressing  or  wasting  it,  and  of  keeping  the  fracture 
in  perfect  rest  by  permanent  extension,  counter-exten- 
sion, and  adjustment,  worked  by  the  aid  of  elastic  straps 
replacing  perfectly  the  contractile  action  of  the  fingers. 
Inflammation  is  sooner  allayed,  the  thigh  almost  com- 
pletely naked  is  exposed  to  the  salutary  influences  of 
the  air  and  light,  and  the  surgeon  can  constantly  follow 
with  the  eye  the  progress  of  the  case,  dispense  with 
assistants,  and  make  applications  and  dressings  to  the 
wounds  very  easily.  In  the  Crimea  and  at  Constanti- 
nople, in  the  experience  of  our  most  skilful  physicians, 
Lustreman,  Thomas,  Salleron,  Maupin,  and  Manny,  many 
legs  and  thighs  were  saved  by  using  this  apparatus  for 

*  This  apparatus  is  thus  described  in  the  Comtes  Rendus  of  the 
Academy,  1 853,  first  part,  p.  854. 

It  consists,  first,  of  a  kind  of  box  open  on  the  top ;  second,  of  an 
inclined  plane;  third,  of  three  cushions  of  hair;  and  fourth,  of  two 
graduated  compresses  with  elastic  strings  for  fastening. 

The  open  box  for  lodging  the  affected  limb  should  be  about  thirty 
inches  long,  eight  wide  at  the  place  for  the  thigh,  and  only  seven 
where  the  leg  and  foot  are  placed.  It  is  made  of  four  pieces ;  the 
bottom,  two  sides,  and  a  foot  board,  the  latter  moving  upon  hinges 
and  capable  of  being  fastened  by  a  hook.  The  bed  piece  is  horizontal, 
the  sides  about  nine  inches  high  and  pierced  with  three  rows  of  holes 
placed  one  above  the  other  about  as  large  as  to  admit  the  finger.  The 
foot-board  is  of  the  same  height  or  a  little  higher.  The  inclined  plane 
is  designed  to  receive  the  broken  limb,  and  the  cushions  of  hair  to 
form  a  bed  on  the  bottom  of  the  box.  The  two  graduated  compresses 
should  be  of  the  length  and  thickness  of  the  fore-finger,  and  are  to 
be  placed  across  the  limbs  above  the  fractured  parts  to  assist  the 
action  of  the  adhesive  straps.  The  limb  is  placed  upon  cushions,  the 
parts  adjusted  and  held  in  position  by  elastic  straps,  fastened  by  adhe- 
sive straps  operating  by  extension  and  counter  extension  in  such  a 
manner  as  to  supply  a  pressure,  much  like  that  of  the  fingers  of  the 
surgeon.  The  numerates  holes  afford  a  choice  of  selection  for  points 
of  attachment  of  the  elastic  straps,  and  enable  the  surgeon  to  apply 
his  tension  as  he  may  have  occasion.  The  foot-board  has  also  holes 
for  a  like  purpose.  The  heel  is  supported  by  a  little  pad  under  the 
tendon  of  Achilles,  and  in  a  later  description  the  sides  of  the  box  were 
fastened  by  hinges  to  the  bottom  so  as  to  adapt  their  inclination  to  a 
given  case. 

Descriptions  of  the  apparatus  and  of  cases  treated  under  it,  were 
read  by  the  author  before  the  Academy  of  Science  at  Paris,  June  30, 
1851,  May  15,  1853,  Aug.  7,  1854,  and  Jan.  15,  1855.— Ta. 


92  THE   CRIMEAN   WAR. 

fractures.  It  is  first  necessary  to  extract  all  splinters  of 
bone ;  their  presence  in  the  flesh  leads  to  an  intermina- 
ble suppuration  and  almost  always  to  death.  After 
these  are  extracted,  the  wound  is  given  such  an  inclina- 
tion as  to  allow  the  ready  escape  of  pus,  and  nature  is 
left  to  work  the  cure  without  hindrance.  Many  cures 
have  been  obtained  without  leaving  noticeable  deformi- 
ties. The  unsightly  callosity,  or  place  of  joining  of  a 
badly  united  fracture,  with  deformity  of  limbs,  has  been 
successfully  reduced  by  the  use  of  this  apparatus,  even 
after  several  months.*  The  shortening  of  the  femur 
corresponding  with  its  loss  of  bone  may  generally  be  dis- 
guised by  using  a  high-heeled  boot. 

Amputations  of  the  thigh  are  the  more  serious  on 
account  of  their  proximity  to  the  trunk,  it  is  therefore 
very  important  to  avoid  them.  Although  disarticulation 
at  the  knee  ought  to  be  done  immediately,  that  of  the 
hip  does  not  succeed  so  well,  but  on  the  contrary, 
should  be  delayed  some  days  after  the  injury  is  receiv- 
ed. This  remark  is  very  important,  for  it  allows  of 
attempts  being  made  to  save  the  limb.  The  upper 
extremity  of  the  femur  is  chiefly  formed  of  spongy  tis- 
sue, more  easily  traversed  than  solid  bone,  and  the 
ball  finding  less  resistance,  does  less  injury.  We  may 
then  apply  the  apparatus,  for  we  run  no  risks,  as,  if  it 
fails,  we  may  still  resort  to  amputation. 

In  the  upper  extremities,  we  may  very  often  avoid 
amputations,  and  preserve  the  limbs,  not  only  by  taking 
away  the  splinters,  but  by  resection,  a  method  of  ope- 
rating, which  gives  most  admirable  results.  These 
resections  I  had  often  practised  on  the  battle-field, 
or  advised  and  explained  in  books  and  lectures.  It 
was  with  much  satisfaction  that  I  saw  the  surgeons 
in  the  Crimea  more  cautious  as  to  amputation,  and 
performing  resections  as  often  as  possible,  instead  of 
taking  oft'  the  entire  arm.  Resections  apply  to  the 
salient  angles  of  fractures,  happening  in  the  body  of 
long  bones,  or  at  their  articular  extremities.  The  perios- 
teum, or  membrane  covering  the  bone,  must  be  prc- 

*  See  Appendix. 


THE   CRIMEAN   WAR.  93 

served  with  the  greatest  care ;  as  M.  Flourens  has 
shown,  that  it  is  this  membrane  that  secretes  bony 
tissues,  and  that  it  will  reproduce  them,  if  left  in  place. 
The  grand  triumph  of  resection  is  when  it  is  practised 
upon  the  head  of  the  humerus.  An  officer  of  high  rank, 
M.  Bertier,  who  submitted  to  this  operation,  is  now  colonel 
of  the  86th  regiment,  and  uses  very  well  the  arm  that 
was  operated  upon,  although  it  is  a  little  shorter  than 
the  other.  A  sergeant-major,  M.  Plombin,  upon  whom, 
at  the  age  of  twenty-three,  I  performed  the  same  opera- 
tion in  Algeria,  is  now  colonel  of  the  1st  regiment.* 

Thanks  to  resection,  an  isolated  fracture  of  the 
radius,  or  of  the  ulna,  does  not  necessarily  require  the 
loss  of  the  limb,  and  I  have,  with  success,  taken  out 
almost  the  whole  of  one  of  these  bones.  Even  where 
both  bones  are  fractured,  they  are  not  always,  unless 
with  grave  complications,  a  subject  of  amputation. 
We  may  say  as  much  of  fractures  of  the  body  of 
the  humerus.  Resections  are  useful,  not  only  for  saving 
the  limb,  but  for  securing  a  more  ready  cure.  We 
should  observe  as  well  as  possible,  our  rules  of  conser- 
vative surgery.  Especially  in  fractures  of  the  hand, 
it  is  important  that  we  should  be  imbued  with  this 
precept,  and  that  we  should  apply  it  in  all  its  vigor. 
We  should  never  forget  that  the  misshapen  stump  of  a 
finger  may  still  be  very  useful.  Eight  years  ago,  in 
June,  1848,  they  brought  in  a  captain,  to  have  his  right 
wrist  amputated,  in  consequence  of  a  gunshot  wound. 
I  succeeded  not  only  in  avoiding  amputation,  but  in 
saving  the  little  finger,  half  of  the  index  finger,  and  the 
thumb.  This  officer  can  still  hold  a  sabre,  and  has  con- 

*  The  author,  in  a  paper  read  before  the  Academy  of  Sciences,  vol. 
xxvi.,  1855,  performed  fourteen  operations  for  resection  of  the  head  of 
the  humerus,  all  of  which,  but  one,  had  succeeded.  When  the  head 
of  this  bone  has  been  broken  by  a  ball,  he  regards  resection  as  the 
rule  to  be  followed,  and  amputation  the  exception.  By  his  method, 
the  limb  did  not  necessarily  remain  suspended  from  the  shoulder,  as 
sometimes  happens,  but  he  obtained  in  most  cases  a  good  joint, 
where  the  glenoid  cavity  of  the  scapula  was  intact.  The  end  of  the 
amputated  bone  should  be  brought  in  contact  with  this  cavity,  and 
all  muscular  fibres  should  be  carefully  removed,  only  a  simple  incision 
was  made  and  no  flap.— TR. 


94  THE   CRIMEAN   WAR. 

tinned  to  serve.  I  met  him  in  the  Crimea,  the  colonel 
of  a  regiment,  and  to  bring  himself  to  my  recollection, 
he  showed  me  his  hand. 

We  cannot  so  often  practise  resection  upon  the  lower 
extremities,  especially  in  time  of  war,  when  the 
wounded  are  liable  to  long  and  painful  removals.  Being 
the  means  of  support,  the  lower  limbs  must  be  more  solid 
than  the  arms.  The  very  voluminous  muscles  render 
less  accessible  to  the  hand  of  the  surgeon,  the  splinters 
of  the  femur  than  those  of  the  humerus.  A  comminuted 
fracture  of  the  two  bones  of  the  leg,  is  often  a  cause  of 
amputation  ;  but  if  the  wounded  can  endure  the  perils 
of  transportation  to  a  well  furnished  establishment,  we 
should  try  to  save  it.  When  the  tibia,  or  the  fibula,  is 
only  broken,  the  resection,  or  even  the  simple  extrac- 
tion of  the  splinters,  often  suffices  to  lead  to  a  cure. 
Perforations  of  the  foot,by  bullets,  are  less  grave  than  were 
formerly  supposed,  and  by  the  extraction  of  the  splin- 
ters, we  may  almost  always  avoid  amputation.  In 
June,  1848,  M.  Thayer,  now  a  senator,  received  a  wound 
of  that  kind,  and  the  extraction  of  the  splinters  with 
long  continued  application  of  refrigerants  led  to  a  per- 
fect cure. 

The  most  terrible  enemy  which  the  surgeons  of  the 
army  of  the  East  had  to  encounter,  was  Hospital 
Gangrene.  This  pestilence,  like  typhus,  springs  from 
concentrated  and  prolonged  mephitism,  so  difficult  to 
avoid  in  armies  stationed  for  a  length  of  time  in  crowd- 
ed tents.  It  arises  spontaneously,  is  propagated  by  the 
air,  or  by  means  of  direct  contagion  by  the  deposit 
upon  a  healthy  wound,  of  matter  coming  from  a  surface 
infected  with  gangrene.  The  second  mode  of  exten- 
sion would  not  be  so  serious,  if  care  was  taken  to  burn 
all  the  linen  which  had  been  used  in  dressing  gangre- 
nous wounds,  with  the  view  of  preventing  its  being 
used  again.  The  air  is  so  obviously  the  vehicle  of 
infectious  miasms,  that  hospital  gangrene  always  shows 
a  tendency  to  increase  or  decline,  according  as  the  wards 
are  more  or  less  encumbered. 

Hospital  gangrene  attacks  the  wounded,  as  well  as 
those  whose  wounds  are  not  entirely  cicatrized  j  and  at 


THE   CRIMEAN   WAE.  95 

the  time  when  the  poor  wounded  men  have  just 
readied  the  end  of  their  cure,  and  are  preparing 
to  return  to  their  families,  they  perish,  victims  of  this 
horrible  disease !  We  recognise  this  terrible  malady, 
when  the  wound  grows  dry,  and  becomes  painful  and 
slate-colored,  with  black  patches.  A  gangrenous  dis- 
organization breaks  out,  attacking  by  preference  the 
cellular  tissues,  of  which  it  eats  out  deep  excavations. 
At  times,  instead  of  a  humid  gangrene,  the  skin  becomes 
covered  with  a  dry  scab ;  and  at  other  times,  while  the 
wound  is  healing  on  one  side,  it  is  increased  in  size  by 
ulcerations  on  the  other.  This  is  called,  "ulcerated  hos- 
pital gangrene."  At  the  beginning,  a  reddish  violet  circle 
from  a  fifth  to  a  third  of  an  inch  wide,  is  formed  around 
the  circumference  of  the  wound.  In  three  or  four  days, 
this  falls  into  a  gangrene,  and  another  circle  succeeds ; 
it  becomes  gangrenous  in  its  turn,  causing  great  destruc- 
tion of  the  substance,  often  attended  with  alarming 
hemorrhages.  This  kind  of  local  typhus  does  not  hesi- 
tate to  invade  the  whole  organism,  and  death  presently 
follows,  if  art  proves  powerless,  or  cannot  seasonably 
intervene. 

The  first  remedy,  and  that  without  which  all  others 
are  powerless,  is  to  isolate  the  infected,  in  non-contami- 
nated places.  This  isolation  is  at  the  same  time  de- 
manded— in  the  interests  of  the  sick,  tainted  with  the 
pestilence,  and  in  those  of  the  neighboring  sick,  who 
may  be  exposed  to  contagion.  The  tent  is  here  an  ex- 
cellent resource,  especially  if  each  one  of  those  attacked 
can  have  one  by  himself.  The  air  is  then  easily  renewed, 
as  it  is  only  necessary  to  fasten  up  the  sides  a  few  inches 
from  the  ground,  to  secure  a  constant  and  very  salutary 
ventilation ;  the  bed  being  above  the  openings,  the  patient 
does  not  suffer  any  inconvenience.  When  hospital  gan- 
grene is  once  established  in  a  hospital,  it  is  very  difficult 
to  get  rid  of  its  contagious  miasms ;  and  it  is  necessary  to 
abandon  it  for  a  time,  whitewash  the  walls,  frequently 
sprinkle  the  floors  with  chlorides,  and  fumigate  tho- 
roughly. In  this  way  alone  can  it  be  conquered. 

The  local  treatment  consists  in  cauterizing  with  a  red 
hot  iron,  or  with  the  perchloride  of  iron,  a  powerful 


90  TUB   CRIMEAN   WAR. 

caustic,  which  penetrates  easily  into  all  the  sinuosities 
of  the  wound ;  this  treatment  M.  Salleron  employed 
with  success.  Dressings  of  lemon  juice,  pulverized 
charcoal,  and  quinquina,  with  camphor,  are  secondarily 
useful  with  caustics.  Continued  lotions  of  cold  water, 
falling  drop  by  drop,  are  also  a  disinfectant,  an  excel- 
lent modifier  of  the  disease,  and  a  constant  sedative  of 
pain.  Injections  of  the  tincture  of  iodine,  which  M.  Yel- 
peau  commonly  employed,  also  give  advantageous 
results.  But  still,  these  are  only  auxiliaries ;  caustics 
and  cauteries  alone  can  stop  the  progress  of  hospital 
gangrene,  and  suppress  the  sources  of  the  putrid  fluids 
that  infect  the  whole  economy. 

There  were  5,000  to  6,000  cases  of  frost-bite,  during 
the  two  winters  of  1855  and  1856  ;  and  the  facts  ob- 
served, presented  noticeable  peculiarities.  In  1855,  the 
cold  was  not  very  intense,  but  there  were  abundant 
rains,  and  the  soil  remained  soaked  a  long  time,  especially 
in  the  trenches.  The  feet  of  the  soldiers,  immersed  in  the 
icy  water,  suffered  from  the  effects  of  frost,  similar  to 
that  in  1836,  before  the  walls  of  Constantinople.  It 
produced  a  tumefaction,  attended  with  redness  and  gan- 
grenous spots,  more  or  less  defined.  Freezing  repro- 
duced the  six  degrees  of  change,  admitted  by  Dupuy- 
tren  in  burns ;  we  know  that  cold  and  heat  produce  the 
same  effects.  The  disorganization  acts  by  a  humid 
gangrene. 

On  the  contrary,  in  the  rigorous  winter  of  1856, 
when  the  thermometer  often  descended  to  five  degrees 
below  zero  of  Fahrenheit,  we  often  observed  dry  and 
sudden  gangrene.  The  sick,  when  being  transported  to 
the  field  hospitals  upon  chairs,  and  the  soldiers  sleeping 
in  tents,  had  their  extremities  frozen.  The  extreme 
cold  expelled  the  liquids,  the  feet  dried  up,  were  reduced 
in  volume,  turned,  so  to  speak,to  parchment,  became  a 
dirty  white,  and  finally,  formed  a  dry,  black  eschar,  like 
in  a  mummy. 

In  Russia,  when  they  travel  in  sledges  without  taking 
the  precaution  of  covering  the  nose  and  ears  with  furs, 
it  happens  that  the  parts  in  like  manner  become  sud- 
denly white,  wrinkled,  and  deprived  of  life.  The  ears  of 


THE   CRIMEAN   WAR.  97 

our  soldiers  were  preserved  by  red  cloth  caps  called  the 
chachia^  which  were  distributed  to  them.  Among  the 
soldiers  who  conducted  the  wagon  trains,  and  who 
were  obliged  to  be  out  in  all  kind  of  weathers,  we  most 
frequently  observed  the  effects  of  rigorous  cold  ;  many 
of  them  had  one  or  more  fingers  of  the  rein-hand  frozen. 
Frozen  feet  were  very  common  in  all  the  regiments.  The 
soldiers  took  care  to  be  always  moving,  and  would  call 
out  to  those  of  their  comrades  whom  they  saw  standing 
still,  careless  or  indifferent,  "  you  will  freeze ;"  unfortu- 
nately, they  were  not  mistaken.  When  cold  acts  upon 
the  whole  surface  of  the  body,  it  does  not  produce  very 
much  suffering,  but  a  simple  dulness  throughout,  and 
an  irresistible  desire  to  sleep,  which  is  fatal  if  indulged  in, 
especially  after  having  drunk  alcoholic  liquors  in  excess. 

If  limited  to  the  feet  or  hands,  the  action  of  cold  is 
first  announced  by  a  painful  numbness.  A  horse-soldier 
whose  right  hand  had  been  frozen,  said  that  he  had  first 
felt  a  numbness  in  the  ends  of  his  fingers,  but  that  soon 
after  they  seemed  to  warm,  and  he  felt  it  no  more.  The 
recurrence  of  cold  rendered  it  difficult  for  him  to  hold 
the  reins,  and  soon  his  fingers  formed  a  rigid  hook  around 
which  he  fixed  them.  He  was  so  imprudent  as  to 
approach  a  fire,  and  lost  all  his  fingers  by  gangrene. 
He  should  have  begun  by  rubbing  his  hand  with  snow, 
and  should  only  have  recalled  warmth  and  life  by  degrees. 

Until  the  parts  struck  dead  by  congelation  drop  off, 
the  suffering  is  very  slight ;  the  appetite  remains,  and 
there  is  but  a  very  moderate  amount  of  fever  of  elimina- 
tion. They  were  satisfied,  under  my  advice,  to  wrap 
the  limb  in  soft  folds  of  wadding,  the  light  and  silky 
contact  of  which  is  agreeable  ;  the  patients  enjoyed 
their  food,  and  often  congratulated  themselves  that  the 
affection  was  not  serious ;  but  unhappily,  when,  a  little 
after,  the  toes,  or  a  half  of  the  foot,  or  both  feet,  begin- 
ning to  putrify,  separated  from  the  body,  leaving  exposed 
a  large  wound,  which  contact  with  the  air  irritated,  the 
pain  became  violent,  a  fever  was  kindled,  the  large  vis- 
cera became  affected,  life  was  endangered,  and  often 
death  supervened,  mocking  the  efforts  of  medical  art. 

In  proportion  as  the  circular  limits  of  the  living  and 


98  THE   CRIMEAN   WAR. 

the  dead  parts  enlarged,  the  suppuration,  already  fetid, 
became  more  abundant,  and  the  softened  parts  became 
detached  in  shreds,  bringing  with  them  pieces  of  the 
skeleton.  The  bones  remaining  in  place,  deprived  of 
their  nourishing  ligaments,  grew  black,  and  finally  fell 
off  of  their  own  accord.  This  labor  of  separation  by 
nature,  though  slow  and  patient,  must  be  scrupulously 
respected.  If,  to  hasten  it,  we  seek  to  shake  a  single 
joint  of  the  finger,  scarcely  held  by  its  eroded  ligaments, 
the  wound  will  not  fail  to  become  covered  with  fleshy 
granulations  of  a  bad  kind,  flabby,  bloated,  bleeding  at 
the  least  touch,  and  always  threatened  with  hospital 
gangrene.  Amputations  made  in  the  Crimea,  on  account 
of  freezing,  were  not  successful.  M.  Boudier,  chief  phy- 
sician of  one  of  the  field  hospital  divisions,  in  one  of  his 
reports,  attributed  this  failure  to  the  shattered  and 
wasted  condition  of  the  sick,  almost  all  of  whom  were 
tainted  with  chronic  diarrhrea.*  The  cases  of  conge- 
lation happening  even  in  the  field  hospitals,  were  a  mani- 
fest proof  of  this  debility.  The  inefficiency  of  the  ope- 
rations imposed  the  duty  upon  the  surgeon  to  abstain 
from  them,  and  to  limit  his  treatment  to  cleanliness, 
disinfecting  the  wound  by  dusting  on  it  with  chloride  of 
lime,  and  leaving  to  nature  alone,  the  effort  of  separat- 
ing the  dead  parts.  This  forbearance  of  the  surgeon 
proves  the  fact,  that  nature  draws  the  line  of  demarca- 
tion between  the  living  and  the  dead  part  much  better 
than  the  hand  of  the  operator,  and  with  much  less  sacri- 
fice. Art  assigns  to  amputations  certain  places,  which 
often  oblige  the  sacrifice  of  portions  of  a  member  that 
might  be  saved,  while  nature,  entirely  conservative, 
never  takes  off  any  part  that  can  possibly  live.  In  ob- 
serving the  operations  of  nature,  we  may  be  convinced 
that  the  indication  of  places  called  preferable,  is  often 
theoretical,  arbitrary,  and  not  sustained  by  experience, 
and  that  we  may  amputate  precisely  at  the  line  of  der- 
marcation  between  the  healthy  and  the  diseased  parts.f 

*  To  thig  cause  we  may  also  ascribe  the  unfavorable  results  ob- 
tained by  double  amputations,  that  is,  of  two  limbs  at  a  time. 

f  The  U.  S.  Sanitary  Commission  has  issued  a  tract,  prepared  by  a 
committee  of  associate  medical  members,  on  the  subject  of  amputations 


[THE  CRIMEAN  WAE.  99 

Upon  these  principles  I  have  now  for  several  years  per- 
formed a  series  of  partial  amputations  of  the  foot.  The 
war  of  the  East  has  furnished  a  host  of  examples  which 
I  may  use  as  arguments.  Even  before  I  visited  the 
Crimea,  I  found  in  the  hospital  at  Marseilles  among  the 
wounded  sent  to  France,  three  hundred  soldiers  affected 
with  partial  freezing  of  the  feet,  which  were  healed,  or 
in  process  of  healing,  although  art  had  not  intervened, 
and  nature  alone  incurred  the  expense  of  a  cure.  Nature 
takes  no  notice  of  the  decisions  of  savans  in  fixing 
places  of  preference.  If  a  part  of  a  toe  can  be  saved, 
even  when  all  the  others  are  dead,  she  saves  it.  I 
have  seen  upon  two  patients,  the  second  phalanx  of  the 
little  toe  left,  after  the  spontaneous  separation  of  all  the 
other  toes;  and  in  others,  only  the  thumb  and  little 
finger  remained.  Nothing  is  more  diversified  or  more 
ingenious  than  the  conservative  operation  of  nature. 
The  surgeon  must  imitate  it  only,  or  let  her  take  her 

through  the  foot  and  dt  the  ankle  joint,  in  which  they  arrive  at  the 

following  general  conclusions : 

"  I.  In  all  amputations  of  the  Lower  Extremity  the  surgeon  should  be 

governed  in  the  selection  of  the  point  of   operation,  and  the 

method  to  be  adopted, 

1.  By  the  mortality  of  the  operations  in  question. 

2.  By  the  adaptability  *of  the  stump  to  the  most  serviceable 
artificial  limbs. 

II.  In  all  injuries  of  the  foot,  involving  parts  anterior  to  the  medio- 
tarsal  articulation,  the  surgeon  should  sacrif\ce  as  little  as  possible 
of  the  structures  essential  to  progression.     He  should  preserve 

1.  Single  phalanges,  the  importance  of  which  increases  from  the 
small  to  the  great  toe ; 

2.  The  metatarsus,  by  amputation  of  the  phalanges,  or  by  the 
excision  of  individual  metacarpal  bones ; 

3.  The  tarsus,  by  amputation  at  the  tarso-metatarsal  articula- 
tion.    (Hey's  or  Lisfranc's  method.) 

III.  Of  the  amputations  through  the  tarsus,   or  at  the  ankle  joint, 
preference  should  be  given  to  S}Tme's  operation  as  affording  a 
minimum  mortality,  with  a  stump  best  adapted  to  an  artificial 
limb. 

IV.  In  the  after  treatment  of  the  amputations  and  resections  above 
considered,  it  is  good  practice  to  leave  the  wounds  open  to  heal  by 
granulation." 

The  above  tract  has  been  furnished  to  all  surgeons  in  the  present 
army  service,  and  is  designated  as  G.  in  the  series  of  monographs  upon 
surgical  and  medical  specialities,  published  by  the  Commission. 


100  THE   CRIMEAN   WAK. 

course.  Let  us  see  how  she  proceeds  :  The  portion  of 
bone  to  be  separated  dries  up,  becomes  black,  and  pro- 
jects. At  its  base,  the  living  flesh  swells  out,  covered 
with  granulations,  and  encroaches  upon  the  bone,  which 
finally  falls  off  of  itself,  leaving  a  deep  hole.  The  gra- 
nulations fill  this  cavity  rapidly,  and  thus  the  stump  be- 
comes covered  with  soft  parts,  in  the  best  possible  man- 
ner. The  surgeon  should  not  interfere,  unless  nature  is 
powerless,  and  even  then  he  should  assist  with  caution, 
for  he  has  reason  to  apprehend  hospital  gangrene.  This 
was  the  opinion  of  M.  Thomas,  physician-in-chief  at 
Constantinople,  who  observed  that  the  slightest  effort 
to  extract  a  bone,  scarcely  held  by  the  ligaments,  almost 
always  induced  hospital  gangrene,  and  he  therefore  left 
to  nature  entirely,  the  task  of  finishing  the  amputation 
of  parts  mortified  by  freezing.  It  was  not  until  1856, 
that  the  hygienic  condition  of  the  hospitals  became 
such,  that  Messrs.  Thomas  and  Lustreman  could  prac- 
tise amputations  with  success.  In  the  field,  the  best 
treatment  is  fraught  with  great  danger.  Latterly  Pro- 
fessor Chassaignac  has  amputated  the  dead  parts  of  a 
gangrenous  limb,  thus  relieving  the  patient  of  the  bur- 
den of  the  lost  member,  stopped  the  source  of  wasting 
putrid  fluids  which  infected  the  whole  system,  and  ev7en 
allayed  pain,  in  relieving  by  division  of  the  bones,  the 
choking  up  of  the  marrow  which  they  contained.  This 
practice  is  good  in  common  cases,  but  in  the  East,  it 
would  invariably  invite  an  attack  of  hospital  gangrene. 

We  see  what  cares  devolve  upon  the  military  sur- 
geon in  times  of  war.  The  soldier  has  only  to  evince 
heroism  on  the  battle-field,  and  a  still  greater  heroism  in 
obscure  labors,  and  fatigues,  and  privations,  bravely 
endured  ;  but  the  surgeon  has  not  only  in  his  own  per- 
son to  share  a  large  part  of  these  pains  and  perils,  but 
also  to  seek  to  relieve  those  of  others ;  he  must  also 
in  the  midst  of  active  labors,  often  too  severe,  work  in 
his  mind,  to  devise  the  best  method  for  performing  one 
or  another  operation,  and  of  conducting  the  treatment, 
which  is  ever  varying  according  to  the  circumstances. 
Every  one  knows  that  the  first  part  of  this  task  was  per- 
formed by  the  physicians  of  the  army  of  the  East  with 


THE    CRIMEAN    WAR.  101 

devotion,  and  the  army  itself  proclaimed  the  sincerity  of 
its  regrets,  when  it  saw  slowly  passing  to  the  cemetery, 
borne  by  maimed  soldiers,  and  followed  by  generals, 
military  intendants,  and  officers  of  every  grade,  the  coffin 
of  M.  Mercier,  chief  physician  of  the  field-hospital  of 
the  right,  who  was  decorated  after  the  taking  of  the 
Malakof,  and  died  two  months  after  in  the  midst  of 
his  sick.  Day  and  night  he  had  remained  in  the  field 
hospital  at  Carenage,  depriving  himself  of  necessary 
sleep,  until  he  laid  himself  down  to  die.*  I  wish  to 
demonstrate  in  a  few  words  that  in  the  fulfilment  of 
the  second  part  of  their  task,  that  of  scientific  observa- 
tions, we  found  in  our  surgeons  the  same  attention  and 
activitv. 


CHAPTER  III. 

THE   PHYSICIANS. — CHLOROFORM. — EUPATORIA. 

HAVING  carried  my  investigations  into  all  the  regi- 
ments, and  taken  account  of  their  several  organizations, 
and  the  causes  of  sickness  and  deaths,  I  often  met  the 
surgeons  in  scientific  councils,  where  we  mutually  enlight- 
ened each  other  on  different  subjects,  and  each,  accord- 
ing to  his  ability,  gave  his  experiences,  and  profited  by 
those  of  others.  These  conferences  always  ended  by  a 

*  The  funeral  honors,  due  to  medical  officers  ill  the  French  service, 
are  as  follows : 

Inspectors  are  followed  by  three  det'achments,  when  the  death 
occurs  in  active  service,  and  by  two,  when  in"retirement. 

Principals,  by  two  detachments  when  the  death  occurs  in  active 
service,  and  by  one  when  in  retirement. 

Majors,  by  one  detachment,  whatever  may  have  been  their  position 
at  the  time  of  death. 

Aides-Major^  by  a  half  detachment,  whatever  their  position  ;  physi- 
cians and  apothecaries  commissioned  by  the  minister  of  war,  receive 
the  same  honors  as  the  aides-major  of  regular  rank. 

In  the  common  salutations  of  the  camp,  sentinels  "present  arms," 
upon  the  passing  of  inspectors,  and  "  carry  arms,1'  when  a  principal 
or  aide-major  passes. 


102  THE   CRIMEAN   WAK. 

session  in  the  amphitheatre.  M.  Scrive,  chief-physician  of 
the  army  of  the  Crimea,  to  which  he  rendered  great  ser- 
vices, usually  attended  us  thither.  We  caused  all  kinds  of 
operations  to  be  repeated  before  us  upon  the  dead  body 
by  the  army  surgeons,  with  the  view  of  ascertaining 
the  most  capable,  in  order  to  place  them  as  circumstances 
required  at  the  head  of  important  trusts.  A  great  num- 
ber of  health  officers  attended  daily  at  these  practical 
reunions.  I  was  often  invited  to  give  them  advice 
and  examples,  which  I  cheerfully  did,  and  thus  not  only 
acquired  great  influence,  but  was  able  to  excite  among 
them  a  laudable  emulation,  so  that  they  carried  even  to 
the  battle-field,  an  ardent  relish  for  study.  These  ses- 
sions proved  quite  an  attraction,  and  the  Sardinian  and 
English  physicians,  and  Sir  John  Hall  among  others, 
honored  them  sometimes  with  their  attendance.  French 
science  was  there  worthily  represented.  Under  the 
empire,  at  least,  half  of  our  army  physicians  had  never 
received  their  medical  degree,  and  had  neither  the  abi- 
lity nor  the  legal  right  to  make  prescriptions,  and  hold 
the  rank  of  practising  physicians.  Now,  the  officers  of 
health  are  recruited  only  from  doctors  of  the  regular 
faculty,  who  are  not  admitted  without  being  subjected 
to  a  new  examination.  All  are  educated  men,  author- 
ized by  law  and  their  diplomas  to  practise  medicine. 

This  was  a  necessary  reform.  Does  not  the  military 
surgeon  require  a  large  amount  of  knowledge  and  expe- 
rience so  that  he  shall  never  fall  short  of  his  mission, 
and  be  able  at  any  moment  to  practise  the  most  nume- 
rous and  grave  operations  ?  And  yet  it  is  not  in  the 
operations  alone,  however  important  they  may  be,  that 
he  finds  the  greatest  difficulties  to  overcome.  In  ampu- 
tations, the  rules  for  tying  arteries  are  known  and  esta- 
blished beforehand ;  he  has  had  hundreds  of  opportuni- 
ties to  practise  in  the  amphitheatre,  and  acquire  a  cer- 
tain sleight-of-hand,  in  such  operations.  Upon  the  bat 
tie-field  the  variety  and  number  of  the  missiles  produce 
at  each  moment  an  unforeseen  combination  of  wounds 
most  fearful  to  manage  ;  here,  in  place  of  previous 
rules,  everything  must  be  extemporized.  We  must  act 
quickly,  to  save  the  life  which  is  gushing  from  the 


THE   CRIMEAN   WAR.  103 

wound.  On  this  bloody  theatre,  it  is  not  enough  to  be 
learned ;  a  quick  eye,  and  prompt  intelligence  always 
alive  to  the  occasion,  are  required.  It  is  this  instinctive 
genius,  always  so  precious  and  necessary,  that  I  would 
wish  to  see  developed  at  the  school  of  Val-de-Grace, 
among  the  students  who  are  to  supply  the  health  service 
of  the  army.  They  should  receive  more  instruction  in 
the  difficult  problems  of  military  surgery,  oftentimes 
reduced,  as  they  are,  to  the  resource  of  expedients ;  show 
them  how,  with  the  blade  of  a  sabre,  the  ramrod  of  a 
gun,  a  bayonet,  and  even  some  pieces  of  a  cloak,  the 
apparatus  ibr  a  fracture  may  be  had  on  the  field  of 
combat.  At  least  they  should  take  a  thorough  course 
upon  gunshot  wounds,  and  other  wounds  of  war ;  but, 
singular  to  remark,  a  special  chair  upon  the  wounds 
of  war  has  not  yet  been,  established  at  Val-de-Grace. 
It  is  true  this  department  is  not  neglected,  for  the 
professors  seize  with  eagerness  all  occasions  to  initiate 
their  pupils  into  the  practice  of  military  medicine, 
and  the  treatment  of  these  wounds ;  but  we  may 
be  allowed  to  hope  that  the  treatment  of  gunshot 
wounds,  instead  of  being  left  to  the  chance  teaching  of 
many  chairs,  and  different  professors,  will  be  deemed  of 
sufficient  importance  to  be  confided  to  a  special  teacher. 
Already  Marshal  Vaillant,  the  minister,  with  whom  the 
soldier's  health  is  an  object  of  constant  care,  has  endowed 
Val-de-Grace,  since  June,,  1857,  with  a  special  chair  of 
diseases  and  epidemics  of  armies.  The  department  to 
which  I  allude,  would  add  a  new  lustre  to  the  reputa- 
tion of  Val-de-Grace.  It  is  true,  that  to  fully  compre- 
hend the  importance  of  these  special  lessons,  and  to 
illustrate  their  bearings  upon  the  higher  departments  of 
science,  a  long  course  of  practice  is  necessary  on  the 
field  of  actual  warfare ;  but  the  pupils  of  Val-de-Grace 
would  find  at  least  in  the  writings  of  our  illustrious  pre- 
decessors, especially  Percy  and  Larrey,  a  host  of  practi- 
cal illustrations,  a  rich  nomenclature  of  the  incidents  of 
war,  and  ingenious  methods  of  treatment ;  and  they 
will  learn  how  a  surgeon  may  overcome  every  difficulty, 
which  war  continually  offers. 

These  difficulties  are  innumerable.    Let  us  remember, 


104  THE   CRIMEAN   WAR. 

however,  that  in  the  Crimean  war,  surgical  science  was 
first  aided  by  a  recent  discovery  due  to  the  re- 
searches of  M.  Flourens,  and  which  iintil  then  had  not 
been  used  on  the  battle-field.  We  allude  to  the  anaesthetic 
action  of  chloroform,  whose  wonderful  effect  in  reliev- 
ing the  terrible  pains  of  the  wounded,  has  been  often 
useful  in  healing  their  wounds.  Its  use  permits  us  to 
trim  wounds,  mortal  in  appearance,  which  the  surgeon 
would  not  have  ventured  to  treat  with  so  much  energy, 
for  fear  of  exciting  new  sufferings.  These  wounds 
being  thus  treated,  become  less  painful,  and  sometimes 
we  are  astonished  at  their  unexpected  cure.  For  exam- 
ple;  a  soldier  of  the  57th  regiment  received  in  the 
upper  part  of  his  thigh  a  piece  of  a  bomb  weighing 
2  kilogrammes,  150  grammes  (4.74  Ibs.).  This  enor- 
mous piece  of  iron  buried  itself  so  deeply  that  only  a 
small  projecting  corner  could  be  seen.  Chloroform 
permitted  the  extraction  of  this  mass,  and  afterwards 
amputation,  without  the  patient  suffering  the  least  pain, 
and  he  rallied.  Without  this  agent,  we  should  have 
hesitated  to  attempt  the  operation. 

By  subduing  pain,  chloroform  gives  a  calmness  and 
mental  tranquillity  to  the  wounded,  very  favorable  to 
healing.  It  deprives  the  traumatic  fever  of  an  excess 
of  reaction,  often  caused  by  the  anxiety  of  the  patient. 
Before  the  discovery  of  this  precious  agent,  some  sol- 
diers, it  is  true,  endured  amputations  without  a  groan. 
I  have  seen  an  Arab  continue  to  smoke  his  pipe,  while 
I  took  off  his  arm  ;  but  this  paroxysm  of  courage,  gained 
by  a  great  exaltation,  fell  some  days  after  into  a  nervous 
depression,  so  much  the  more  dangerous  on  account  of 
the  stoicism  which  had  hitherto  sustained  him.  There- 
fore, those  surgeons  who  know  how  dangerous  it  is  to 
struggle  against  suffering,  tell  their  patients  not  to 
resist  it,  but  to  let  it  express  itself  in  cries.  I  remember 
an  unfortunate  soldier,  who,  having  decided  to  allow  his 
leg  to  be  cut  off,  exclaimed :  "They  told  me  it  was  no- 
thing— that  some  sing  under  the  operation  ;  I  should 
like  to  see  them  !'' 

We  know  that,  in  great  operations,  death  ensues 
oftener  from  nervous  prostration,  consequent  upon 


THE   CRIMEAN   WAR.  105 

excess  of  suffering,  than  from  haemorrhage.  It  is  the 
same  with  animals.  M.  Claude  Bernard  observed,  that  in 
laying  open  the  spinal  column,  in  experiments  upon  rab- 
bits, they  always  died  at  once,  unless  they  had  pre- 
viously been  rendered  insensible  by  chloroform. 

But  used  imprudently,  this  agent,  while  it  takes 
away  suffering,  may  also  take  away  life.  It  shares  this 
sad  privilege  with  the  most  potent  remedies ;  taken 
in  large  doses,  they  are  for  the  most  part  poisonous, 
and  kill  instead  of  curing.  The  danger  may  perhaps  be 
certainly  avoided,  by  observing  certain  rules,  and  espe- 
cially by  not  pressing  the  inhalation  to  its  extreme 
limits.  This  extreme  limit  is,  in  my  opinion,  when  in 
accordance  with  the  precept  laid  down  for  several  years, 
we  pass  the  stage  of  insensibility  and  reach  that  of  col- 
lapse^ and  a  complete  muscular  prostration.  This  condi- 
tion is  reached,  when  a  limb  is  lifted  up,  and  falls  like  a 
mass  of  dead  matter,  for  then,  life  almost  borders  upon 
death,  it  has  retired  into  the  vital  centre,  placed  by 
M.  Flourens  in  the  medulla  oblongata,  at  the  origin  of 
the  eighth  pair  of  nerves  which  absolutely  control  the 
function  of  the  heart  and  lungs.  To  approach  this 
point,  is  rash  temerity :  to  reach  it,  is  death.  This 
rashness  appears  to  me  unjustifiable.  We  ought  always 
to  stop  when  insensibility  is  reached ;  it  is  enough  for 
the  patient  that  the  pain  is  alleviated.  The  surgeon 
may  find  it  convenient  to  cause  a  prostration  of  the 
vital  powers,  but  should  abstain  from  affecting  it  by 
such  dangerous  means.  The  movements  of  the  patient 
are  easily  restrained  by  the  assistants,  and  if  not  entirely 
repressed,  I  would  even  then  abstain  from  its  use.* 
The  physicians  of  the  army  of  the  East  were  of 
this  opinion,  and  administered  chloroform  with  great 
prudence,  stopping  at  the  point  of  insensibility,  and 
never  intentionally  exceeding  it.  They  had  therefore 
no  fatal  accidents  to  deplore,  although  in  the  campaign  of 
the  East  this  agent  was  employed  at  least  thirty  thou- 
sand times.  In  the  Crimea  alone,  it  was  administered 

*  I  have  given  this  precept  all  the  proofs  necessary  in  a  memoir 
read  at  the  Institute,  July  19,  1853. 

9 


106  THE   CRIMEAN   WAR. 

to  more  than  twenty  thousand  wounded,  according  to 
the  estimate  of  M.  Scrive.  The  physicians  of  the  Sar- 
dinian army,  at  the  beginning  of  the  campaign,  hesitat- 
ed to  use  it,  but  the  success  of  our  surgeons  soon 
gave  them  confidence  in  its  efficacy.  Henceforward  we 
may  have  a  steadfast  confidence  in  chloroform,  and 
thank  Providence  for  having  allowed  human  skill  to 
invent  an  agent  that  can  suspend  pain.* 

Epidemics  made  such  ravages  among  our  physicians, 
that  after  the  taking  of  Sebastopol,  the  field  hospital  of 
the  left  division  was  converted,  upon  the  requisition  of 
M.  Scrive,  into  a  special  home  for  convalescents  belong- 
ing to  the  personal  service  of  this  department.  It  was 
located  upon  the  heights  of  Sebastopol.  It  had  its  share 
of  sorrow.  A  little  lamp  lighted  for  use  at  night,  was 
observed  by  the  Russians,  and  made  a  target  for  their 
guns.  Their  bombs  crashed  through  the  roof.  We 
hastened  to  carry  away  the  sick  upon  mule-litters,  and 
when  the  danger  had  passed  they  were  brought  back. 

In  front  of  this  hospital  a  magnificent  panorama 
spreads  itself.  Towards  the  south,  bounded  by  a 
horizon  of  vast  extent,  the  sea  was  covered  with  the 
supply  ships  of  the  allied  armies ;  to  the  north  a 
splendid  road  without  rocks  or  sandbars,  finely  shelter- 
ed from  the  winds,  and  easy  of  access,  was  dotted  with 
vessels  destroyed  by  the  hand  of  man  ;  and  at  the  head 
of  the  harbor,  the  granite  docks  and  marine  railways, 
masterpieces  of  human  skill,  which  were  going  to  be 


*  The  English  surgeons,  in  the  Crimea,  employed  chloroform  very 
generally,  and  McLeod  considered  their  confidence  in  its  efficacy 
greater  than  among  the  French.  Only  one  well  established  fatal  case 
occurred  from  its  use,  while  a  great  number  of  operations  were  suc- 
cessfully performed  which  would  have  otherwise  not  been  attempted. 
The  morale  of  the  wounded  was  better  sustained,  and  the  courage 
and  comfort  of  the  surgeons  increased.  Its  moderate  use  was  not 
found  to  result  in  depression,  but  on  the  contrary  it  often  supported 
the  strength  of  the  patient  under  the  operation,  and  it  was  never 
more  successful  than  when  used  immediately  after  the  injury, 
before  the  constitution  had  begun  to  suffer  from  the  nervous  irritation 
liable  to  follow  a  wound.  It  acts  more  rapidly  upon  persons  who 
have  lost  much  blood,  and  henco  more  care  is  necessary  in  such 
cases. 


THE    CRIMEAN    WAR.  107 

destroyed,  challenge  our  wonder,  and  suggest  fruitful 
themes  of  reflection.  Beyond  these,  arose  three  for- 
midable lines  of  Russian  batteries,  while  still  beyond 
lay  the  camps  of  the  enemy,  spread  over  a  plain  of 
great  extent ;  to  the  east  irregular  mountains,  com- 
manded by  the  bastion  of  Malakof. 

As  for  Sebastopol,  this  city,  lately  so  proud  and  so 
menacing,  presented  only  a  spectacle  of  mingled  ruins 
and  tombs,  with  great  heaps  of  disabled  cannon,  and 
broken  gun  carriages,  balls,  shells,  and  bombs.  In  walk- 
ing about  it  was  necessary  to  avoid  the  channels  swept 
in  enfilade  by  the  Russian'artillery,  and  to  thread  our  way 
with  difficulty,  through  the  encumbered  and  obstructed 
streets  cut  in  the  steep  ridges  of  this  promontory,  which 
could  not  be  attacked  in  front.  The  house  occupied  by 
General  Levaillant,  Governor  of  Sebastopol,  was  not 
bomb-proof,  as  was  made  evident  by  large  openings  in 
the  roof.  The  general  led  me  to  a  corner  of  his  little 
garden,  where  he  had  built  his  observatory,  and  lent  me 
his  spy-glass.  We  could  observe  very  distinctly,  the 
Russians  on  the  other  side  of  the  harbor,  loading  and 
pointing  their  cannon  at  us ;  but  their  shot  passed  over 
our  heads. 

These  shot  often  committed  ravages,  through  the 
carelessness  of  our  soldiers,  who  exposed  themselves 
rashly  and  needlessly ;  they  had  seen  so  many  of  them, 
that  they  took  no  care  to  avoid  them.  This  negligence 
added  new  wounded  to  our  field  hospitals ;  but  epide- 
mics were  the  chief  agencies  in  filling  them.  Surgical 
operations  diminished  and  gave  place  to  therapeutic 
treatment.  The  sick,  coining  in  by  crowds,  encumbered 
our  hands,  and  obliged  us  to  send  to  the  regular  hospi- 
tals all  cases  of  an  obstinate  character.  A  field  hospital 
admits  readily  of  expansion,  according  to  its  wants ;  it 
is  only  necessary  to  bring  into  use  more  tents,  houses, 
or  barns,  as  they  may  be  needed  from  day  to  day.  It 
is  necessary,  however,  to  hasten  as  much  as  practicable 
the  distribution  of  the  sick  among  the  various  hospitals, 
in  numbers  of  five,  or  at  most,  six  hundred  men  to  each. 
If  this  number  was  exceeded  to  double  or  treble,  as  it 
often  happened,  we  ran  great  risk  of  miasmatic  infection. 


108  THE   CRIMEAN    WAR. 

This  peril  is  encountered  even  in  times  of  peace,  when 
we  accumulate  at  a  given  point  a  large  number  of  sick ; 
and  in  extensive  hospital  establishments,  the  relative 
mortality  is  much  greater  than  in  those  of  small  extent, 
notwithstanding  every  hygienic  precaution.  This  truth 
is  not  generally  admitted,  except  by  medical  men,  and 
it  is  usually  held  that,  by  a  system  of  centralization,  the 
service  is  better  attained ;  we  violate  the  laws  of  health, 
prolong  the  stay  of  the  sick  in  the  hospitals,  increase  the 
number  of  invalided  and  of  deaths,  and  generate  infec- 
tious diseases.  With  the  view  of  emptying  the  field 
hospitals  of  the  Crimea,  we  opened  in  December,  1855, 
some  new  hospitals  at  Constantinople.  I  went  to  visit 
them,  after  having  continued,  by  way  of  Eupatoria,  my 
tour  of  inspection. 

Eupatoria  is  a  large  city,  which  the  Russians  would 
have  burned  had  they  found  time,  but  we  saved  it  from 
ruin.  Its  houses  are  mostly  one  story  high,  and  very 
spacious,  especially  those  bordering  upon  the  larger 
streets.  The  principal  thoroughfares  are  much  cut  up, 
and  very  muddy  in  winter,  but  they  are  bordered  by 
sidewalks  about  twenty  inches  above  them,  which  are 
sheltered  by  overhanging  roofs.  At  this  time  the  city 
was  occupied  by  the  Allies.  Only  a  poor  part  of  the 
population  remained.  The  Avealthy  had  retired,  but  the 
poor  were  increased  by  the  daily  arrival  of  the  unfortu- 
nate villagers  from  the  country  around,  who  said  they  had 
been  burnt  out  by  the  Russians.  They  were  not  only 
received,  but  fed  by  the  Allies ;  I  have  seen  biscuit  dis- 
tributed to  more  than  a  thousand  children,  who  in  return 
performed  such  services  as  they  were  able,  for  the  corps 
of  engineers.  The  sanitary  condition  of  the  French 
troops  was  very  satisfactory,  and  we  counted  but  300 
sick  in  an  effective  force  of  12,000  men.  Such  a  result 
could  not  be  attained,  even  in  France ;  it  is  due  to  the 
continuance  of  fine  weather,  an  abundance  of  provisions 
of  good  quality,  which  were  regularly  distributed ;  and 
finally,  to  the  military  evolutions  that  were  executed, 
which  preserved  the  soldiers  in  a  high  state  of  morale. 
The  corps  of  Generals  D'Allonville  and  Failly,  which 
harassed  the  enemy,  showed  very  few  sick  upon  their 


THE   CRIMEAN    WAR.  109 

rolls;  and  the  pleasure  of  burning  ammunition,  combined 
with  their  successes,  soon  transformed  the  young  recruits 
into  veteran  soldiers. 

These  corps  were  encamped  under  shelter-tents,  which 
would  become  unserviceable  as  soon  as  the  first  rains 
should  soak  the  ground.  Would  it  not  have  been  better 
to  lodge  our  troops  in  the  city  itself?  It  was  showing 
too  much  respect  for  the  property  of  our  enemies ;  the 
inhabitants  would  have  been  as'ked  neither  beds  nor 
blankets,  but  only  a  roof  to  shelter  the  men  against  the 
rains,  and  the  rigors  of  a  winter  which  we  knew  would 
be  inclement.*  There  was  an  abundance  of  houses. 
The  diseases,  it  is  true,  were  not  serious,  but  the  dan- 
gers of  an  unhealthy  camp  might  increase  their  number, 
and  enhance  their  severity.  In  anticipation  of  this,  the 
field  hospitals  were  arranged  under  sheds  in  an  immense 
area,  inclosed  with  walls,  and  having  for  their  depen- 
dencies three  fine  houses  which  might  afford  accommo- 
dations for  two  hundred  beds.  It  would  be  easy  to 
prepare  tents  in  the  courts,  if  needed.  The  physicians 
were  assembled  in  conference,  various  measures  were 
discussed,  and  attention  was  called  to  the  Turkish  field 
hospitals,  from  whence  the  germs  of  epidemics  might 
perhaps  arise.  The  15,000  Turks  and  Egyptians,  assem- 
bled at  Eupatoria,  had  many  thousand  sick,  chiefly  of 
scurvy,  which  they  sent  to  Varna.  Their  field  hospitals 
were  well  arranged,  but  unfortunately  were  attended 
by  few  physicians  worthy  of  the  name.  It  was  agreed 
with  Achmet-Pacha,  General-in-Chief,  that  certain  effec- 
tive measures  should  be  taken,  under  the  supervision 
of  M.  Bourgillon,  chief  physician  of  our  hospital,  and 
one  of  the  most  distinguished  of  our  medical  officers, 
who  would  thus  learn  the  peculiarities  and  sanitary  con- 
dition of  the  sick  in  the  Turkish  and  Egyptian  armies. 
M.  Bourguillon  was  highly  gratified  in  the  relations 
with  M.  Cassini,  chief  physician  of  the  Egyptian  army, 
who  conducted  a  difficult  service  with  much  ability. 


*  This  suggestion,  made  in  my  report  to  the  Minister  of  War,  and 
to  Marshal  Pelissier,  was  attended  to,  and  the  army  took  up  its  winter 
quarters  in  a  portion  of  Eupatoria. 


110  THE    CRIMEAN   WAK. 

Our  Mahomedan  allies,  less  scrupulous  than  ourselves, 
seized  for  their  use  all  the  houses  of  consequence,  even 
the  mosques,  and  the  magnificent  Hebrew  synagogue, 
which  was  one  of  the  finest  in  the  world.  They,  how- 
ever, gave  up  to  us,  of  their  own  accord,  two  large 
houses,  well  furnished  with  hospital  furniture. 

In  the  Turkish  field  hospitals,  as  in  the  English,  the 
physicians  enjoyed  great  authority  in  their  administra- 
tion and  control.  Their  attendants  were  soldiers  of  long 
service,  but  too  young  to  be  pensioned  for  retirement, 
who  generally  evinced  much  zeal,  because  the  loss  of 
their  place  would  deprive  them  of  all  right  to  a  pension. 
The  food  was  composed  largely  of  mutton  and  chicory. 
In  the  East,  mutton  is  abundant  and  of  good  quality, 
but  beef  is  scarce,  lean,  and  poor.  Encouraged  by  this 
example,  I  desired  that  mutton  and  chicory  should 
sometimes  be  distributed  to  the  hospitals  instead  of 
broth  and  boiled  beef,  deeming  it  proper  that  in  dis- 
tant countries  wre  should  avail  ourselves  of  the  resources 
of  the  locality,  and  adopt  wise  modifications  in  our  regi- 
mental customs.  We  borrowed  another  practice  from 
the  Turks : — that  of  frequently  fumigating  the  wards  of 
the  sick,  by  throwing  dried  sage  upon  a  pan  of  burning 
coals.  The  aroma  thus  occasioned,  is  agreeable;  it 
rapidly  and  completely  renovates  the  air  contaminated 
with  miasms,  and  if  we  open  for  a  moment  the  doors 
and  windows,  the  fumes  soon  escape.  This  ancient 
mode  of  purification  is  not  to  be  despised.* 

The  want  of  Medical  Science,  which  the  Turks  have 
long  felt,  will  be  soon  supplied,  as  the  Sultan  has  founded 

*  The  English  Sanitary  Commissions  were  not  favorably  impressed 
with  the  results  of  fumigations.  The  deodorizing  substances  used, 
diminished  the  odor,  but  not  in  the  same  ratio  the  disease ;  and  they 
expressed  decidedly  the  opinion  that  they  should  never  be  trusted  to 
for  protecting  health,  if  it  be  possible  to  remove  the  nuisances  at  once 
and  to  a  distance.  They  observe  that  "  burial  of  putrid  refuse  to  a 
sufficient  depth,  when  removal  is  impossible,  or  when  the  substance 
cannot  be  destroyed  by  fire,  is  a  safer  expedient  than  removing  its 
smell  by  charcoal,  or  by  any  other  deodorizing  agent  scattered  over  its 
surface.  Smell  is  indeed  the  natural  index  to  danger,  and  removal  or 
destruction  of  the  offensive  matter  is  the  remedy.  There  is  reason  to 
fear  that  after  the  smell  is  removed  the  danger  remaiqs." — TB. 


THE   CRIMEAN   WAR.  Ill 

at  Constantinople,  a  school  of  medicine,  in  which  five 
hundred  pupils  are  collected.  The  more  intelligent  are 
to  be  sent  to  Paris  to  finish  their  studies,  and  this 
nursery  for  the  education  of  young  men  will  confer 
great  services  upon  the  Ottoman  army,  and  spread 
among  their  co-religionists  our  ideas  and  our  customs. 

Upon  leaving  the  Crimea,  I  went  to  inspect  not 
field  but  general  hospitals.  The  first  condition  of  the 
latter  is  their  permanence.  At  Constantinople,  these 
vast  establishments  increased  and  multiplied  daily. 
They  were  far  from  the  enemy,  and  were  sheltered  from 
all  danger  from  abroad.  They  were  near  enough  to  the 
Crimea  for  easy  communication  ;  they  were  on  the  sea- 
shore, and  the  means  of  transportation  were  easy.  Their 
organization  was  excellent. 

Shut  out,  by  the  blockade  of  Sebastopol,  from  trans- 
portation by  sea,  the  Russians  were  compelled  to  remove 
,their  sick  in  four-wheeled  waggons,  without  springs, 
drawn  by  three  horses,  and  arranged  for  four  patients, 
of  whom  the  two  that  were  best  able  to  endure  it  were 
seated  upon  a  kind  of  bench,  while  the  other  two  lay 
upon  straw.  Rude  as  this  conveyance  was,  it  proved 
very  acceptable  to  the  Russian  soldiers,  and  by  this 
means  of  conveyance  they  were  sent  to  Baghtchehsarai' 
and  Sympheropol,  where  15,000  beds  were  arranged  in 
various  hospital  establishments.  They  underwent  great 
exposures,  and  often  suffered  intense  cold  upon  this  long 
journey,  and  the  mortality  among  these  unfortunate 
men  was  very  great. 

The  English  waggons,  used  for  moving  the  sick,  were 
suspended  upon  good  springs.  Two  beds  laid  upon, 
litters  were  placed  in  the  carriage,  after  the  manner  of 
drawers,  and  the  sides  were  made  of  light  rails,  to 
insure  the  circulation  of  fresh  air.  Such  men  as  could 
travel  without  lying  down,  sat  in  a  kind  of  covered  seat 
placed  in  front,  and  others  even  rode  upon  the  top, 
when  the  weather  permitted. 

Our  ambulance  waggons  were  well  hung  on  springs, 
and  proved  a  great  luxury.  A  covered  seat  in  front 
received  such  of  the  wounded  as  could  sit  up,  and 
in  the  other  part,  arranged  like  an  omnibus,  two  sick 


112  THE    CRIMEAN  WAB. 

could  lie  upon  litters  placed  on  the  sides.  The  seats 
were  elastic,  well  cushioned,  and  covered  with  red 
sheepskin  leather.  These  carriages  were  heavy,  and 
but  little  used,  as  we  preferred  to  use  mules,  provided 
with  chairs  or  litters.  In  a  campaign,  the  simplest 
measures  are  always  the  best.  Nevertheless,  although 
these  carriages  were  very  comfortable,  it  was  of  great 
advantage  that  their  use  was  confined  to  removal  to 
short  distances ;  to  the  infirmaries  and  field  hospitals, 
and  from  thence  to  the  place  of  embarkation.  The  fleet, 
whose  business  it  was  to  supply  our  army  with  neces- 
saries of  every  kind,  rendered  also  great  assistance  in 
transporting  from  the  Crimea  to  Constantinople,  many 
of  the  sick  who  could  never  have  recovered  their  health 
in  the  Crimea. 


PART    III. 

THE  HOSPITALS  AND  THEIR  DISEASES.— 
TYPHUS  IN  THE  CRIMEA. 

IT  was  not  against  the  Russian  arms  alone  that  the 
allied  troops  of  the  Crimea  were  forced  to  struggle. 
Those  acquainted  with  the  history  of  long  campaigns 
are  aware  that  accidental  or  endemic  diseases  commit 
greater  ravages  among  soldiers,  than  gunpowder  and 
the  sword.  Besides  the  hygienic  precautions  necessary 
to  preserve  those  in  health,  and  the  care  demanded 
by  the  wounded/the  wants  of  the  sick  and  convalescent 
press  incessantly  upon  the  military  administration  the 
most  painful  problems  of  medical  science.  If  we  review 
the  history  of  our  hospital  establishments  during  the 
war  in  the  East,  this  fact  will  be  shown ;  and  I  trust  that 
the  administration  and  science  will  never  cease  from 
their  exertions  until  these  problems,  which  are  the 
highest  aim  of  their  double  task,  are  solved. 


CHAPTER     I. 
THE    CHOLERA. 

IT  will  be  remembered  that,  at  the  beginning  of  the  war, 
Gallipolis  was  selected  as  a  place  for  assembling  the 
various  contingents  arriving  from  the  several  ports  in 
the  south  of  France,  and  from  Algeria.  This  peninsula 
was  to  be  made  the  strategic  point  of  the  army  of  the 
East,  and  the  base  of  its  operations.  By  the  active 
forethought  of  General  Canrobert,  it  has  been  rapidly 
converted  in  reality  into  a  military  station,  devoted 

6* 


114  THE    CRIMEAN    AVAK. 

to  camps  and  provision  stores  of  all  kinds,  including 
materials  for  regular  and  field  hospitals.  Each  had 
upon  the  front  of  its  color  line,  its  particular  guidon, 
and  each  had  its  separate  cantonment.  As  new  regi- 
ments debarked,  they  pitched  their  tents  upon  undu- 
lating but  elevated  grounds,  whose  salubrity,  recognised 
in  advance,  is  preserved  by  the  fresh  sea  breeze.  The 
energies  of  the  medical  corps  of  the  army  were  directed 
to  putting  into  force  certain  sanitary  measures,  which 
were  also  applied  to  the  city  of  Gallipolis  itself.  They 
had  to  struggle  against  the  well  known  indolence  of  the 
Mahommedans,  before  they  could  obtain  the  removal 
of  heaps  of  rubbish  and  filth,  that  endangered  the  health 
of  the  town.  In  oriental  cities,  this  duty  is  left  to  be 
discharged  by  the  sun  and  winds,  the  former  having  for 
its  share  to  calcine  tha  heaps  of  filth,  and  reduce  them 
to  powder,  when  the  winds  are  expected  to  carry  them 
away.  The  horrible  stench  of  these  accumulations  of 
rubbish  seems  a  standing  invitation  to  epidemics. 

While  the  brigades  were  being  organized,  the  old 
athletic  and  bronzed  soldiers,  who  had  served  in  Algeria, 
sought  to  initiate  their  comrades  into  martial  usages, 
and  as  war  was  something  new  to  them,  to  accustom 
them  to  the  habits  and  life  of  the  camp.  They  under- 
took to  teach  them,  according  to  their  picturesque 
expression,  how  to  handle  the  tools,  that  is  to  say,  how 
to  endure  hardships  like  themselves,  and  how  to  be  pre- 
pared to  practise  the  art  of  resisting  the  inevitable  pri- 
vations of  the  campaign,  and  at  the  same  time  to  retain 
their  health.  General  Canrobert  did  not  leave  the 
troops  inactive,  but  accustomed  them  to  the  fatigues  of 
war,  by  making  them  labor  upon  earth  works,  and 
construct  immense  trenches  around  their  camps,  ren- 
dering them  as  capable  of  defence  as  forts.  With 
the  assistance  of  the  English  army,  they  fortified  the 
peninsula  of  Gallipolis  by  entrenchments  which  ex- 
tended from  the  gulf  of  Saros  to  the  sea  of  Marmora ; 
these  works  were  to  close  against  the  Russians  the 
passage  of  the  Dardanelles,  which  they  had  opened  in 
1829.  Besides  being  useful  in  a  military  point  of  view, 
they  served  a  sanitary  purpose,  with  the  most  happy 


THE   CRIMEAN   WAR.  115 

results.  The  number  of  the  sick  at  Gallipolis  was  not 
large,  and  most  of  these  had  only  slight  indispositions, 
which  kept  them  but  a  few  days  in  the  field  hospitals. 
A  hospital  with  three  hundred  beds,  established  a  kilo- 
metre (0*62  miles)  from  the  city,  took  the  place  of  some 
houses  in  the  town  which  had  been  temporarily  occu- 
pied by  our  sick,  and  abundantly  sufficed  for  the  first 
necessities  of  the  army.  This  first  hospital  barracks 
of  the  French  army  was  established  in  May,  1854. 
Placed  near  the  route  of  the  fleets,  upon  the  shores  of 
the  Dardanelles,  at  a  point  where  lighters  could  easily 
land,  it  was  used  by  us,  after  the  departure  of  the  armies, 
with  the  greatest  advantage.  At  this  hospital,  the  sick 
on  their  way  to  France  from  the  Crimea  and  Constanti- 
nople were  left,  when  it  was  found  they  could  not 
encounter  the  voyage  without  danger.  It  therefore 
became  an  appendage  to  the  hospitals  at  Constantinople. 

We  had  at  first  committed  the  error  of  constructing 
the  barracks  upon  low  grounds,  with  the  view  of  util- 
izing some  ruins,  and  to  be  near  a  spring;  but  this 
fault  was  subsequently  remedied,  when  it  became  neces- 
sary to  extend  our  hospital  resources.  At  a  place  but 
fifty  yards  distant,  we  found  an  elevated  and  well  aired 
plateau,  where  we  prepared  several  barracks,  with  beds 
sufficient  for  300  sick.  The  hospitals  at  Gallipolis,  when 
thus  completed,  had  600  beds,  and  were  always  well 
managed  by  the  intelligent  and  devoted  medical  atten- 
dants under  the  care  of  Dr.  Molard.  I  found  the  litters 
and  furniture  in  complete  condition,  and  the  bread, 
wine,  meat,  and  broth  of  good  quality. 

But  the  events  of  a  campaign  advance  with  rapidity ; 
and  when  once  assembled,  our  troops  did  not  remain 
long  at  Gallipolis.  Nearly  a  hundred  thousand  Rus- 
sians, followed  by  large  reinforcements,  laid  siege  to 
Silistria,  which  was  bravely  defended  by  eighteen 
thousand  Turks.  The  troops  of  Omer-Pacha  amounted 
to  a  hundred  thousand  combatants,  but  they  were 
scattered  at  many  points,  chiefly  at  Routschouk,  Silis- 
tria, and  Chumla.  This  barrier  might  be  overthrown 
at  any  moment  by  the  invading  army,  and  it  appeared 
urgent  that  we  should  hasten  to  the  assistance  of  the 


116  THE    CRIMEAN   WAR. 

Turks,  and  place  Adrian ople  in  condition  for  defence  by 
a  prompt  movement.  Each  movement  of  the  army 
required  the  creation  of  new  centres  for  hospital  ser- 
vice. 

On  the  7th  of  May,  1854,  the  Marshal  Saint  Arnaud 
arrived  at  Gallipolis,  reviewed  our  enthusiastic  army, 
and  left  bis  instructions  to  embark  at  once  for  Constan- 
tinople, to  which  place  he  went  himself  the  next  day. 
He  imparted  his  own  activity  to  all  whom  he  approach- 
ed, and  his  lively  and  animated  tones  excited  life  even 
in  the  Ottoman  authorities.  The  sultan  himself  con- 
fided in  the  marshal,  and  ordered  all  the  resources 
of  his  empire  to  be  placed  at  the  disposal  of  the 
generals  of  the  allied  armies.  Activity  succeeded 
the  slowness  and  hesitation  of  the  Ottoman  administra- 
tion, so  accustomed  to  leave  everything  till  the  mor- 
row. On  the  19th  of  May  the  marshal  and  Lord 
Raglan  went  to  Varna,  held  a  conference  with  Omer 
Pacha,  passed  in  review  at  Chumla  a  corps  of  45,000 
soldiers  of  tried  valor,  and  decided  to  send  forward,  not 
a  single  division  as  he  had  at  first  proposed,  but  the 
whole  available  forces  at  his  disposal.  Varna  then  be- 
came a  new  base  of  operations,  which  left  Gallipolis  a 
secondary  point.  Large  supplies  of  provisions,  ammuni- 
tion, materials  of  war,  and  hospital  supplies  were  hastily 
sent  forward.  On  the  1st  of  June,  6000  troops,  com- 
posing the  first  brigade  of  the  division  of  Canrobert, 
embarked  from  Gallipolis,  and  an  English  detachment 
of  equal  force  at  the  same  time  from  Scutari,  where 
Lord  Raglan  had  his  head-quarters,  and  advanced  by 
land  to  Varna,  about  twenty-three  and  a  half  miles 
distant.  Other  French  regiments  were  to  arrive  by  sea 
and  land,  at  the  common  rendezvous. 

On  the  llth  of  May,  a  barrack  commission,  in  which 
Dr.  Cazalas  represented  the  medical  interests,  assembled 
at  Adrianople,  the  ancient  residence  of  the  Turkish 
sultans,  and  the  capital  of  Roumelia.  This  city,  by  the 
beauty  of  its  climate,  its  wealth,  its  resources  of  every 
kind,  and  especially  its  location,  which  commanded  the 
Balkans,  and  the  route  which  the  enemy  must  neces- 
sarily take,  became  a  strategic  point  of  the  greatest 


THE   CRIMEAN    WAE.  11 7 

importance.  They  hastened  to  place  at  our  disposal 
an  immense  barrack,  built  in  1820  by  order  of  the  Sul- 
tan Mahmoud.  It  formed  a  parallelogram  about  490 
yards  long  from  north  to  south,  and  300  yards  wide 
from  east  to  west,  built  with  a  ground  floor  and  one 
story.  The  angles  were  relieved  by  square  four-story 
towers,  each  surmounted  by  a  gallery  and  terrace,  with 
a  staff  from  which  floated  the  national  colors.  In  the 
centre  of  the  principal  arcade  was  the  entrance  to  the 
pavilion  of  the  sultan,  quite  in  oriental  style.  It  was 
supported  by  many  storied  ranges  of  white  marble 
columns,  among  which  the  winds  played  freely,  and  had 
a  grand  portico  of  sculptured  marble  adorned  with 
gilded  arabesques.  Five  large  marble  basins,  each 
furnished  with  twenty  large  copper  spouts,  and  fed  by 
an  aqueduct,  furnished  an  abundant  supply  of  good 
water.  There  was  a  wide  difference  between  this 
monument  of  taste  and  our  barracks  in  France,  where 
rigid  economy  allows  no  freedom  to  the  inspirations 
of  the  architect.  The  premises  we  have  described 
could  lodge  10,000  soldiers,  and  contained  2*78  rooms 
receiving  light  from  1280  external  windows.  It  was  at 
once  decided  that  a  hospital  for  1200  sick  should  be 
established  in  a  part  of  this  magnificent  barrack,  and 
to  remedy  as  much  as  possible  the  inconvenience  of  so 
great  a  concentration  of  sick  it  became  necessary  to  as- 
sure each  patient  at  least  45  yards  of  air.  In  our 
hospitals  the  common  measure  is  from  24  to  26  yards, 
and  in  our  barracks  from  16  to  18  yards.  Subsequent 
events  having  rendered  Adrianople  less  important  as  a 
military  point,  we  reduced  the  number  of  beds  to  300. 

On  the  16th  of  June,  when  the  division  under  General 
Bosquet,  amounting  to  11,435  men,  and  the  troops  of 
General  Morris,  composed  of  about  1200  cavalry,  arrived 
at  Adrianople,  a  hospital  was  prepared  to  receive  169  sick 
and  250  lame.  The  former  division  left  for  Varna  on 
the  25th  of  June,  but  the  cavalry  regiments  of  General 
Morris  did  not  follow,  and  at  a  later  day  they  left  their 
bivouacs  on  the  plain  of  Tundja  for  the  barracks  where 
they  passed  the  winter  of  1855. 

The  first  French  hospital  established  at  Constantino- 


118  THE    CRIMEAN    WAR. 

pie  was  that  of  Maltepe,  and  the  first  sick  that  were 
received  belonged  to  the  third  division,  commanded  by 
Prince  Napoleon.  This  division,  having  left  Gallipolis 
May  28th,  proceeded  by  land  along  the  borders  of  the 
Sea  of  Marmora  to  Constantinople,  leaving  their  sick 
and  lame  about  half  way  at  Rodosto,  in  a  transient 
hospital  arranged  for  250  beds.  They  would  have 
retained  this  as  well  as  the  barrack  accommodations 
used  by  the  victorious  Russians  in  1829,  had  not 
the  siege  of  Sebastopol  been  decided  upon.  On  the 
7th  of  June,  the  third  division  entered  Constantinople, 
and  bivouacked  on  the  plain  of  Daoud  Pacha,  leaving 
upon  the  minds  of  the  Turks  a  vivid  impression  of 
admiration  and  wonder.  They  saw  with  surprise  the 
oriental  costume  of  our  Zouaves,  which  had  been 
abolished  among  them  by  a  reform,  against  which  the 
old  Ottoman  party  had  protested  ;  they  still  wore,  by  a 
kind  of  tolerated  disobedience,  the  ancient  national 
costume. 

Maltepe  was  a  Turkish  hospital,  one  half  of  which 
was  opened  June  7th  for  a  field  hospital  of  the  third 
division,  and  the  remainder  some  months  after.  At  a 
distance  of  some  2000  yards  from  the  chateau  of  Seven 
Towers  and  the  strong  walls  of  Stamboul,  on  the  west 
side,  appear  in  strong  profile  upon  the  poetic  sky  of  the 
East  the  two  great  permanent  barracks  of  Daoud  Pacha 
and  Ramis-Tchiflik.  They  were  modelled  after  those  of 
Adrianople,  and  were  distinguished  by  an  architecture 
in  which  elegance  did  not  detract  from  solidity.  They 
were  about  a  mile  and  a  quarter  apart,  upon  an  exten- 
sive plain  deprived  of  trees,  but  covered  in  summer  with 
rich  harvests.  The  hospital  of  Maltepe  was  built  be- 
tween the  two  barracks  upon  a  little  eminence  exposed 
constantly  to  the  sea  breeze,  and  of  sufficient  capacity 
for  450  sick. 

The  third  division  was  reviewed  on  the  borders  of 
the  rich  vale  of  the  tombs  of  Eyoub,  by  the  Sultan  and 
his  brilliant  staff;  and  on  the  morrow  (June  18th) 
it  embarked  for  Varna.  The  field-hospitals  followed  this 
movement,  leaving  their  sick  at  Maltepe,  where  the 
suffering  soldiers  sent  from  Rodosto  were  received. 


THE    CRIMEAN    WAR.  119 

From  this  day,  a  hospital  was  definitely  arranged,  at  the 
head  of  which  was  the  learned  chief  physician  M.  Du- 
rand,  who  continued  in  charge  during  the  campaign. 

The  sick  arriving  by  sea,  were  landed  at  the  foot  of 
the  Golden  Horn,  from  whence  the  convalescents 
walked,  while  others  were  transported  upon  litters, 
chairs  carried  by  mules,  or  ambulance  waggons.  The 
road  was  very  narrow  and  steep  as  far  as  the  Porte-des- 
Canons;  the  feeble  were  often  scarcely  able  to  make 
the  journey,  and  the  Turks,  a  people  considered  in  Eu- 
rope as  wanting  in  compassion,  assisted  them  or  made 
them  sit  down.  Upon  reaching  the  external  walls  at  the 
Opening  of  the  Crosses,  the  route  continued  to  rise  by  a 
very  gentle  slope  to  Maltepe.  It  passes  through  the 
immense  cemetery,  planted  with  resinous  trees  and  the 
common  cypress,  which  borders  the  long  western  line  of 
the  ramparts  of  Stamboul.  We  soon  arrive  at  a  little 
historical  hillock,  on  which  is  a  small  windmill,  the  only 
one  on  the  plain.  It  is  here  the  troops  of  the  Sultan 
Mahmoud  were  harangued  by  their  chiefs  and  ulemas 
in  1828,  when  departing  for  Maslak,  where  they  massa- 
cred in  their  camps*  the  revolted  janizaries.  The  hos- 
pital is  200  yards  beyond,  and  from  its  principal  front  is 
displayed  a  beautiful  panoramic  view  of  Constantinople, 
the  Sea  of  Marmora,  the  Princes  Islands,  and  the  Moun- 
tains of  the  ancient  Bithynia,  capped  with  snow.  The 
sick  were  never  tired  of  admiring  this  fine  spectacle, 
which  inclined  them  to  a  calm  and  quiet  meditation,  so 
salutary  in  convalescence. 

The  establishment  at  Maltepe  formed  a  great  rectan- 
gle, and  the  four  sides  inclosed  a  court  of  very  large 
extent  planted  with  trees.  The  walls  were  of  wood  on 
the  side  towards  the  court,  but  of  stone  externally,  and 
the  side  towards  Constantinople  had  only  a  ground-floor 
surmounted  at  the  angles  by  little  turrets.  Externally  it 
was  bordered  by  an  orchard,  cooled  by  refreshing  springs 
received  in  marble  basins,  and  had  in  the  centre  a  monu- 
mental entrance-way  of  white  marble  in  good  Byzantine 
style.  This  range  of  buildings  contains  several  of  the 
hospital  accessories,  such  as  the  Turkish  baths,  the  laun- 
dry, the  kitchens,  the  apothecary  rooms,  the  offices  and 


120  THE   CRIMEAN    WAE. 

two  chambers  of  honor,  one  called  the  Sultan's,  and  the 
other  the  Seraskier's,  or  Minister  of  War.  The  other 
three  sides  of  the  rectangle  contained  a  ground-floor, 
and  one  story  above  it,  along  which,  on  the  side  towards 
the  inner  court,  ran  a  corridor  to  give  access  to  the 
rooms  which  looked  on  the  country.  Each  chamber 
contained  from  30  to  40  Turkish  beds,  which  were  made 
of  large  fir  boxes  sustained  by  iron  legs,  and  contain- 
ing two  mattresses  of  cotton  or  wool.  An  aqueduct, 
abundantly  supplied,  distributed  excellent 'water  through 
the  whole  establishment.  The  artificers  of  the  engineers 
immediately  arranged  everything  to  our  wants,  so  dif- 
ferent from  those  of  the  Turks,  and  this  hospital  con- 
tinued to  be  used  by  us  constantly  until  May  31,  1856, . 
when  the  Crimean  troops  began  their  embarkation  for 
France,  which  was  completed  on  the  5th  of  July  fol- 
lowing, under  the  personal  observation  of  Marshal  Pe- 
lissier. 

Meanwhile  the  ranks  of  the  army,  composed  of  some 
15,000  to  20,000  men,  increased  from  day  to  day,  a  fourth 
Division  having  joined  the  expedition,  and  soon  after  a 
h'fth.  They  all  proceeded  in  succession  to  Varna,  whose 
ramparts  are  situated  at  the  foot  of  a  marshy  valley,  be- 
tween -two  spurs  of  the  Balkan  range.  It  was  taken  by 
the  Russians, in  1828.  The  city  contains  16,000  inhabi- 
tants, and  has  on  one  side  an  extensive  lake,  and  on  the 
other  the  sea.  '  Its  harbor  is  very  difficult  of  access,  and 
offers  but  little  shelter  and  very  poor  anchorage.  Upon 
their  arrival  the  regiments  were  stationed  about  five 
miles  beyond,  where  they  pitched  their  tents  upon  a 
high  plateau  called  Franka,  approached  by  paths  wind- 
ing through  most  beautiful  gardens.  The  elevation 
of  this  plain  was  about  650  feet  above  the  sea,  its 
breadth  from  east  to  west  was  about  two  miles,  it  was 
bordered  by  forests,  and  refreshed  by  many  springs  of 
limpid  water.  The  Russians  had  bivouacked  here  in 
1828;  it  was  in  all  respects  most  suitable  for  the 
encampment  of  an  army.  From  this  point  our  troops 
watched  the  defiles  of  the  Balkan  mountains,  escaping 
the  noxious  miasms  to  which  a  sojourn  in  the  low 
grounds  would  have  exposed  them.  Unfortunately  they 


THE   CRIMEAN   WAR.  121 

committed  indiscretions ;  eat  unripe  fruit,  and  drank 
immoderate  quantities  of  spirits  or  cold  water.  In  the 
evening,  when  the  heat  of  the  day  had  fallen  from  30° 
to  12°,  and  even  10°  Centigrade  (86%  54o  and  50°  Fah- 
renheit), they  would  often  remain  in  the  open  air,  and 
sleep  without  their  clothing,  being  in  this  respect  more 
careless  than  the  inhabitants  of  the  country,  who  avoid 
going  out  of  doors  after  nightfall,  unless  protected 
against  the  low  temperature  and  humidity  by  warm  and 
impervious  clothing. 

Although  the  general  sanitary  condition  was  satisfac- 
tory, yet  a  number  of  men  entered  the  infirmaries,  sick 
with  intermittent  fevers,  and  especially  with  the  intes- 
tinal fluxes,  precursors  of  cholera.  It  became  necessary 
to  create  asylums  for  the  suffering  troops.  The  Ottoman 
authorities  placed  at  our  disposal  a  very  large  permanent 
barrack,  which  we  shared  with  the  English.  It  receif  ed 
700  beds  complete.  The" buildings  were  old  and  in 
bad  condition.  We  contented  ourselves  with  making 
the  motet  necessary  repairs.  It  continued  during  the 
campaign  to  receive  soldiers  from  the  Crimea,  and 
chiefly  from  Eupatoria.  Besides  this  permanent  hospi- 
tal, there  were  established  upon  the  elevated  grounds 
several  large  field-hospitals,  two  of  which  were  exclu- 
sively reserved  to  the  Cholera  patients  from  the  fatal 
expedition  of  the  Dobrutcha.* 

*  The  English  suffered  from  cholera  on  two  occasions  during  the 
Crimean  war.  The  first  epidemic  appeared  in  April,  1854,  increasing 
for  three  months,  and  again  declining  slowly,  and  in  an  irregular  man- 
ner till  February,  1855,  when  it  disappeared.  The  following  month 
marks  a  clear  interval  between  the  two  epidemics,  for  no  case  occurred 
in  the  English  army  in  March,  1855. 

The  second  outbreak  began  in  April,  1855,  culminated  in  June,  and 
declined  slowly  and  irregularly  as  in  the  former.  It  was  less  severe 
than  the  first,  but  showed  a  tendency  to  remain  permanently,  and  after 
a  month's  interval  again  increased,  as  if  to  make  a  third  annual  visit. 
The  total  number  of  cases  that  occurred,  was  7,575,  and  of  deaths 
4,513  or  59-57  per  cent,  of  the  deaths  2,902  were  in  the  first,  and 
1,611  in  the  second  period.  The  cavalry  lost  399,  the  ordnance  460, 
and  the  guards  and  infantry  3,654.  Among  the  prophylactic  measures 
adopted,  were  the  discontinuance  of  parades  and  avoidable  fatigues, 
a  frequent  change  of  encampment,  strict  attention  to  cleanliness  in 
the  camps ;  suppression  of  unripe  fruits,  and  unwholesome  wine  and 


122  THE    CRIMEAN   WAR. 

The  whole  coast  from  Varna  to  the  Danube  is  a  deso- 
late country,  covered  with  steppes  and  marshes,  whose 
neighborhood  is  fatal  during  the  heats  of  summer.  In 
the  spring  of  1854,  Omer  Pasha  said  to  Commandant 
Henry,  envoy  to  his  camp  at  Chumla,  "  If  the  Russians 
remain  another  month  in  the  Dobrutcha,  their  army 
will  be  annihilated : — to  me  it  would  be  equivalent  to 
winning  a  great  battle.''  The  terrible  havoc  made  by 
malignant  epidemics  in  the  Russian  army  in  1828,  could 
not  be  entirely  forgotten ;  and  without  doubt,  the  re- 
membrance of  this,  in  part  decided  the  Russian  gene- 
rals to  quit  the  Dobrutcha  and  to  reascend  the  Danube 
to  Silistria ;  and  which  made  them  abruptly  quit  this 
place  after  a  futile  but  not  fruitless  siege.  The  city, 
breached  on  every  side,  was  on  the  point  of  yielding, 
and  the  vigor  of  its  defenders  was  on  the  point  of  giving 
in  4o  the  numbers  and  desperate  valor  of  the  assailants. 
The  retreat  of  the  Russians  on  the  left  bank  of  the 
Danube  gave  to  the  allied  armies,  who  were  impatient 
to  march  to  the  combat,  a  mingled  feeling  of -painful 
surprise  and  almost  of  discouragement.  Marshal  Saint 
Arnaud  felt  it  was  necessary  to  produce  a  powerful  reac- 
tion in  the  morale  of  the  army,  employ  his  soldiers, 
draw  them  from  fatal  inaction,  and  revive  their  ardor 
by  some  great  movement,  whose  boldness  and  wisdom 
should  draw  the  attention  of  Europe.  At  that  time,  the 
Cabinet  of  St.  James  earnestly  insisted,  that  we  should 
proceed  to  the  Crimea,  destroy  Sebastopol,  and  annihi- 
late the  Russian  fleets  in  the  Black  Sea.  The  instruc- 

spirits ;  the  furnishing  of  a  spirit-ration,  and  an  increased  quantity  of 
fresh  meat,  and  a  portion  of  barley  or  rice  daily  on  medical  represen- 
tation ;  coffee  for  men  returning  from  guard-duty,  and  every  effort  to 
induce  men  affected  with  diarrhoea  to  report  themselves  for  medical 
assistance  in  the  early  stages  of  the  complaint. 

It  was  particularly  urged  to  use  remedies  in  the  early  premonitory 
stages ;  but  with  their  best  efforts  the  influences  of  climate,  vicissi- 
tudes of  temperature,  heavy  dews,  defective  diet,  impure  water,  unripe 
fruits,  and  sour  wines,  operated  against  the  best  devised  measures  for 
relief,  and  defied  the  control  of  the  medical  staff. 

The  greatest  mortality  occurred  at  Varna.  The  period  of  greatest 
intensity  was  in  Dec.  1854,  when  888  cases  in  an  average  strength  of 
29,727  appeared,  and  636  died,  giving  2-9  per  cent,  of  deaths  to  the 
whole  force,  and  7T6  per  cent,  of  admissions. — TR. 


THE    CRIMEAN    WAB.  123 

tions  to  the  Marshal  Saint  Arnaud  were  less  imperative, 
and  left  him  free  upon  this  point.  The  exploration  of 
the  shores -of  the  Crimea  was  therefore  commenced, 
and  as  soon  as  the  enterprise  was  considered  to  be 
practicable,  it  was  irrevocably  decided  upon,  notwith- 
standing the  opposing  advice  of  the  admirals  of  the 
fleet,  who  distrusted  the  sea  at  this  advanced  season  of 
the  year. 

In  the  midst  of  preparations,  occasioned  by  the  pros- 
pect of  early  departure,  the  unmistakable  signs  of  Cho- 
lera took  our  army  by  surprise.  On  the  9th  of  July,  the 
pestilence  appeared  in  the  hospitals  at  Varna,  although 
the  relative  number  of  all  the  sick  at  the  time  was  not 
over  600,  to  the  50,000  men  already  collected ;  it  was 
doubtless  imported  into  the  East  by  the  successive  con- 
tingents of  the  fifth  division,  embarked  in  the  South 
of  France,  where  the  population  was  a  prey  to  this  epi- 
demic. It  first  made  its  appearance  at  Pirea,  and  then 
at  Gallipolis,  where  in  a  few  hours  it  took  oif  gene- 
rals Duke  of  Elchingen  arid  Carbuccia.  The  expedition 
of  the  Dobrutcha  was  not  slow  in  furnishing  new  vic- 
tims. Great  as  was  the  wish  to  transport  the  allied 
armies  at  once  to  the  Crimea,  it  could  not  be  done 
before  fifteen  days,  this  delay  being  necessary  to  make 
the  preparations  for  departure ;  it  was  determined  to 
profit  by  the  opportunity,  and  make  a  demonstration 
that  should  annoy  the  enemy,  and  deceive  them  as  to 
the  plan  of  attack  on  Sebastopol. 

According  to  the  official  reports  of  a  colonel  of  the  staff, 
sent  upon  the  ground,  the  Russians  had  at  45  leagues 
from  Varna,  near  Babadagh,  10,000  men,  with  35vpieces 
of  cannon.  The  three  first  divisions  of  the  .French 
army  were  sent  to  find  them,  and  they  were  directed 
to  proceed  along  the  sea-shore,  for  the  convenience  of 
provisioning.  It  was  thought  that  a  frequent  change 
of  bivouac  would  lessen  the  choleraic  tendencies  of  the 
troops.  On  the  21st  of  July,  General  Espinasse,  who 
commanded  for  the  time  being  the  first  division,  while 
General  Canrobert  was  exploring  the  shores  of  the 
Crimea,  received  orders  to  move  upon  Mangalia,  at  the 
head  of  10,500  men,  of  whom  328  were  officers.  There 


124  THE   CRIMEAN   WAR. 

were  left  in  the  infirmaries  and  hospitals  at  Varna  16 
officers  and  925  soldiers.  The  1st  Regiment  of  Zouaves, 
transported  by  sea  to  Kustendje,  was  to  operate  at  the 
head  of  the  column  under  the  orders  of  General  Yus- 
suf,  and  to  support  2,000  or  3,000  Oriental  cavalry,  orga- 
nized from  the  undisciplined  bands  called  the  bachi- 
bozouks.  The  physician-in-chief  of  this  division  was 
M.  Cazalas,  an  energetic  man,  who  had  evinced  a  tho- 
rough knowledge  of  his  profession  at  the  school  of  Val- 
de-Grace.  He  was  assisted  by  several  chosen  physi- 
cians, Doctors  Quesnoy,  Bailly  who  was  taken  off  a 
few  days  later  wTith  the  cholera, — and  Raoul  de  Long- 
champ,  who  resisted  the  pestilence  as  if  by  a  miracle. 
The  means  of  transportation  intended  for  the  sick,  con- 
sisted of  65  pairs  of  mule-chairs,  5  pairs  of  litters,  some 
ambulance  caissons,  and  a  number  of  arabas,  loaded 
on  starting  with  provisions  for  ten  days,  for  the  use 
of  the  expedition.  Each  soldier  carried  besides  provi- 
sions for  five  days. 

To  accomplish  the  six  and  three-fourth  miles  of  the 
first  stage  from  Franka  to  Kapakli,  the  soldiers  remained 
ten  hours  upon  foot,  exposed  throughout  the.  day  to  a 
heat  of  30°  Centigrade  (86°  Fahrenheit).  In  the  same 
evening  four  cases  of  cholera  appeared.  On  the  22d, 
they  started  at  four  o'clock  in  the  morning,  and  the  divi- 
sion did  not  reach  Tchatal-Tchesme  until  seven  in  the 
evening.  They  travelled  about  eleven  miles,  the  thermo- 
meter rose  to  35°  C.  (95°  F.),  and  the  march  was  very 
difficult,  owing  to  the  route  passing  over  steep  and  gul- 
lied places ;  but  beyond  this  bivouac,  the  column  des- 
cended into  a  naked  plain,  without  trees,  about  124 
miles  in  length,  covered  with  high  herbaceous  stalks, 
many  of  which  lay  rotting  upon  the  ground,  where  they 
formed  a  tangled  mat,  through  which  the  troops  ad- 
vanced with  great  difficulty.  This  was  the  Dobrutcha, 
covered  with  lakes  and  marshes  which  infected  the 
atmosphere,  especially  in  this  season  of  the  year.  Geo- 
graphers have  placed  it  as  between  the  Danube,  and  the 
walls  of  the  camp  of  Trajan,  about  five  miles  from  Kust- 
endje, but  medical  topography  wrould  place  its  southern 
limits  as  far  south  as  beyond  Kavarna,  where  the  troops 


THE   CRIMEAN   WAR.  ]  25 

arrived  three  days  after  leaving  Varna.  The  encamp- 
ments which  marked  the  subsequent  stages  of  the  expe- 
dition were  all  equally  insalubrious.  At  Sattelmuch- 
Gol,  Mangalia,  Orgloukoi,  and  even  at  Kustendje,  as 
in  the  ruins  of  the  village  of  Kergelak,  we  found  no 
place  of  encampment  other  than  low  marshy  grounds, 
whose  waters  were  poisoned  with  vegetable  substances 
in  process  of  decomposition.  As  we  approached  the 
Danube,  we  met  some  parties  of  Cossacks,  who  opposed 
no  serious  resistance ;  the  aspect  of  the  country  became 
more  and  more  desolate,  cultivation  disappeared,  and 
every  trace  of  human  industry  was  lost.  We  met  only 
some  shafts  of  broken  columns,  and  tumuli  of  great  anti-' 
quity,  silent  witnesses  of  former  civilization  against 
modern  barbarism.  Since  the  Russian  invasion  in  1828, 
this  region,  fearfully  ravaged,  had  become  almost 
deserted.  Clouds  of  vultures  followed  our  steps,  to 
devour  the  dead  bodies  which  might  be  left  behind  ; 
it  was  not  unusual  to  meet  troops  of  wild  horses,  who 
took  to  flight  on  seeing  us.  Some  shepherds,  whose 
constitutions  present  the  characteristics  of  paludal 
cachexia,  are  almost  the  only  inhabitants  of  the  Do- 
brutcha;  and  they  are  forced,  like  the  beasts  that  they 
tend,  to  use  foul  water,  dipped  from  the  pools,  cisterns, 
or  abandoned  wells. 

The  army  had  furthermore  to  endure  tempests  of  rain, 
and  numerous  atmospheric  vicissitudes  of  heat  and  cold. 
The  cholera,  which  until  this  time  had  remained  almost 
inoffensive,  no  longer  delayed  to  make  a  sudden  and  fear- 
ful attack.  On  the  night  of  July  30,  300  Zouaves  were 
violently  seized,  and  the  bachi-bozouks  were  also  terribly 
assailed  by  the  epidemic.  General  Yussuf  prepared  to 
march  forward,  but  the  redoubled  strokes  of  the  pesti- 
lence compelled  him  to  fall  back.  His  troops  scarcely 
found  time  to  bury  the  dead  that  fell  by  the  way.  He, 
however,  in  spite  of  all  difficulties,  transported  upon 
gun-carriages  and  upon  horses,  the  sick,  whose  number 
increased  every  moment  with  frightful  rapidity.  The 
column  of  General  Espinasse,  hoping  to  surprise  the 
enemy,  had  made  a  night-march  on  Kargualeck,  without 
knapsacks,  and  with  very  few  waggons,  in  order  to  pro- 


126  THE   CRIMEAN    WAR. 

ceed  more  rapidly,  and  arrived  at  about  one  o'clock  in 
the  morning.  It  started  in  a  rain-storm  which  lasted 
several  hours.  The  following  morning  witnessed  a  sor- 
rowful scene,  for  instead  of  the  enemy,  they  saw  300  sol- 
diers belonging  to  the  1st  regiment  of  Zouaves,  crowded 
into  the  mean  village  ruin,  and  struck  down  with  the 
cholera.  Means  for  transportation  were  wanting.  The 
9th  battalion  of  foot-chasseurs,  forming  the  rearguard, 
showed  a  remarkable  example  of  devotion.  They  took 
up  all  the  sick  upon  litters,  prepared  on  the  spot  with 
their  shelter-tents,  and  poles  found  in  the  village.  The 
column,  ravaged  by  the  pestilence,  retraced  its  steps 
'towards  its  former  bivouac  near  the  great  lake  of  Pallas. 
It  was  compelled  to  leave  in  a  field-hospital,  until  the 
morning,  a  large  number  of  cholera  patients,  which  it 
could  not  carry  away.  On  the  31st  of  July,  the  sur- 
viving portion  of  the  division  arrived  at  Kustendje, 
where  it  found  the  houses  full  of  bachi-bozouks.  About 
1800  cholera  patients  were  awaiting  their  turn  to  embark 
upon  steam  frigates,  and  1,200  dead  bodies  were  buried 
in  trenches  dug  around  the  place. 

The  unexpected  arrival  of  General  Canrobert  at  Kust- 
endje, gratified  the  earnest  wish  of  all,  and  produced  a 
keen  and  touching  emotion.  He  called  a  medical  council ; 
impressed  new  energy  into  the  measures  already  taken 
by  General  Espinasse,  who  was  then  suffering  from 
cholera,  and  revived  the  courage  which  the  disease  had 
checked.  The  division,  making  unheard  of  efforts  to 
transport  the  cholera  patients  which  fell  from  time  to 
time,  arrived  at  Mangalia  on  the  3d  of  August,  where 
the  forethought  of  General  Canrobert  had  brought 
together  resources  of  every  kind,  and  especially  fresh 
provisions,  wine,  brandy,  coffee,  and  sugar.  New  deaths 
were  counted  by  hundreds,  and  2,000  sick  were  embarked 
for  Yarna.  The  marshy  stopping-place  of  Mangalia  was 
rendered  still  more  dangerous  by  the  putrid  decay  of 
many  dead  bodies,  which  the  bachi-bozouJcs  had  left 
lying  about  without  sepulture ;  they  had  thrown  a  very 
large  number  into  pits,  to  avoid  digging  graves,  and  a 
part  of  the  water,  which  had  already  become  rare,  was 
found  to  have  been  thus  poisoned. 


THE    CRIMEAN    WAR.  127 

It  would  have  been  well  to  fly  from  the  places  thus 
infected  as  quickly  as  possible ;  but  the  care  of  the  sick, 
the  havoc  made  in  the  ranks  of  the  medical  men 
who  had  fallen  victims  of  tried  devotion  to  their 
duties,  the  necessity  of  organizing  the  service  of  soldier- 
attendants  from  the  different  regiments,  and  the  time 
required  for  embarking  the  sick  and  for  provisioning 
the  division,  did  not  permit  us  to  leave  for  Varna  before 
the  7th  of  August.  The  pestilence  raged  up  to  that 
time,  but  on  the  9th,  as  soon  as  the  column  arrived  upon 
the  high  plateaux  of  Kavarna  with  its  air  revived  and 
made  wholesome  by  the  forests  of  the  Balkan  moun- 
tains, an  amelioration  in  the  sanitary  condition  was 
quickly  felt,  and  the  epidemic  presently  lost  its  intensity. 
Some  days  later,  the  division  returned  to  its  camp  at 
Franka,  where  it  prepared  large  field-hospital  tents, 
and  under  the  most  favorable  hygienic  conditions.  There 
remained  but  half  of  its  late  effective  strength,  the  other 
half  being  in  the  hospitals,  or  under  the  soil.  The 
loss  of  the  bachi-bozouks  was  still  more  cruel;  M.Cazalas 
estimated,  that  their  deaths  amounted  to  full  half  of 
their  number. 

The  second  division  entered  the  Dobrutcha  after  the 
1st.  Upon  arriving  at  Mangalia  it  found  itself  suddenly 
seized  with  the  cholera,  and  struck  down  without  mercy ; 
but  General  Bosquet,  in  the  course  of  his  operations, 
observed  a  steady  and  firm  policy,  following  faithfully 
the  hygienic  measures  advised  by  the  physicians,  and 
rigidly  enforcing  them.  The  soldiers  on  the  march  never 
neglected  to  make  their  soup  and  coffee,  however  long 
the  day's  journey,  or  scarce  the  water,  which  was  drawn 
from  wells,  few  and  very  deep.  Three  hundred  arabas, 
embracing  the  means  of  transportation  of  the  2d  divi- 
sion, had  been  divided  among  the  different  corps  in  such 
a  way  that  each  had  its  own  provisions  with  it,  and  each 
could  watch  the  peasants,  and  their  oxen,  who  were 
always  ready  to  desert.  This  measure  did  not  prevent 
some  of  the  former  from  taking  flight,  but  they  at 
least  left  their  waggons,  and  the  beasts  that  drew  them. 
The  soldiers  were  made  to  supply  their  place  as  drivers. 
As  the  waggons  were  unloaded  of  their  provisions  by 


128  THE   CRIMEAN    WAR. 

the  daily  consumption  of  the  army,  they  placed  upon 
them  the  sick,  and  thus  greatly  increased  the  ordinary 
transportation  of  the  ambulances.  At  each  bivouac, 
they  dug  large  trenches  to  inter  the  dead.  One  day, 
General  Bosquet  said  to  an  old  soldier,  who,  pipe  in 
mouth,  was  covering  over  his  comrades  with  apparent 
indifference,  "Close  up  this  ditch,  there  are  now  enough 
in  it."  "  I  am  in  time,  general,  and  there  are  more  to 
come,"  replied  the  grave-digger,  who  felt  himself  mor- 
tally struck  with  the  cholera.  A  few  moments  after  he 
fell  into  the  open  ditch,  and  his  body  filled  the  place  which 
he  had  prepared.  The  2d  division  was  not  more  than 
five  miles  from  Varna,  when  the  aide-de-camp  of  the  gene- 
ral-in-chief  came  to  announce  that  the  hospitals  were  too 
full  already,  and  that  they  could  receive  no  more  sick. 
General  Bosquet  replied,  that  he  was  glad  of  it,  as  he 
could  do  without  hospitals,  and  place  the  sick  in  condi- 
tions more  favorable  to  health.  Soon  after,  all  his  sick 
were  provided  for  in  tents  placed  on  the  high  plateaux, 
in  the  midst  of  the  woods.  The  soldiers  discharged 
cheerfully,  and  with  a  good  will  and  singular  devotion, 
the  duties  of  infirmary  attendants.  Many  recoveries 
attested  the  timely  wisdom  of  the  measures  taken,  and 
in  a  short  time  the  cholera,  thus  treated,  became  almost 
harmless.  Mother  Philippon,  who  enjoyed  great  popu- 
larity among  the  soldiers,  was  distinguished  among  all 
the  cantinieres  by  her  indefatigable  zeal.  Day  and 
night  she  was  on  foot,  and  in  the  coarse  vocabulary  of 
the  camps,  in  which  she  excelled,  would  ask  if  they  were 
hungry  or  wanted  anything  to  drink.  The  jokes  of  mo- 
ther Philippon  passed  from  mouth  to  mouth,  and  made 
even  those  laugh  who  had  the  least  inclination  to  do  so. 

The  second  division  had  comparatively  much  less 
cholera  than  the  first ;  and  the  third,  not  having  gone 
beyond  Bojardjik,  was  attacked  with  less  severity  than 
the  second.  This  circumstance  seemed  to  settle  beyond 
doubt  the  fact,  that  the  epidemic  derived  new  energy 
from  the  fatigues  which  our  soldiers  encountered  in  the 
midst  of  a  pestilential  country. 

Some  physicians  ascribe  to  conditions  of  dryness  or 
humidity  in  certain  soils,  an  influence  upon  the  murder- 


THE   CRIMEAN    WAR.  129 

ous  spread  of  cholera.  They  have  pushed  their  in- 
quiries through  the  various  geological  series,  from  the 
granite  to  the  tertiary  formations  inclusive,  and  have 
studied  the  modifications  which  the  epidemic  derives 
from  them;  but  the  facts  observed  almost  mutually 
contradict  each  other.  Some  observers  attribute  an 
immunity  to  dry  granitic  regions,  while  others  declare 
the  same  in  favor  of  marshy  districts,  but  the  Dobrut- 
cha  has  given  the  cruel  lie  to  this  latter  theory.  It 
has  been  asserted,  that  the  cholera  prevailed  in  the 
plain  before  we  penetrated  it,  but  this  statement  seems 
without  any  foundation.  It  is  certain  that  the  comman- 
dant of  the  staff,  M.  Balliard,  who  about  this  time 
visited  the  Danube  side  of  Silistria,  never  heard  the 
cholera  spoken  of,  nor  did  the  army  of  Omer  Pasha  or 
the  village  populations  complain  of  its  presence.  It  can. 
no  longer  be  doubted,  that  the  germ  of  the  epidemic 
was  in  some  way  latent  in  the  ranks  of  our  army,  and 
that  the  slightest  causes  were  only  needed  to  bring  it 
suddenly  into  operation.*' 

If  the  essential  causes  of  cholera  are  unknown,  and  if 
they  are  of  a  nature  to  escape  our  inquiries,  the  circum- 
stances which  propagate  it  are  more  and  more  manifest. 
The  unhappy  experiences  of  the  Dobrutcha  clearly 
prove  that  the  violation  of  hygienic  laws,  insalubrity, 
and  misery,  are  capable  of  exciting  it  into  murder- 
ous activity,  and  constitute  its  true  element.  It  is 
enough  to  know  that  the  revival  of  this  pestilence, 
which  has  so  often  ravaged  the  army  of  the  East,  has 

*  This  generally  received  opinion  is  not  entertained  by  M.  Cazalas, 
according  to  whom  the  choleraic  influence  reigned  evidently  in  the 
Dobrutcha,  before  the  arrival  of  our  army.  "  I  have  myself  seen," 
said  he,  "  cases  of  cholera  among  the  native  population,  and  the  reports 
which  I  have  received  from  these  places  leave  no  doubt  of  the  fact 
It  is,  however,  incontestably  proved  from  the  fact  that  the  1st  divi- 
sion, which  suffered  most,  was  composed  of  regiments  from  Algeria, 
where  cholera  did  riot  prevail  at  the  time  they  left:  and  that  the  bacJii- 
bozoucks,  who  had  never  seen  either  France  or  Algeria,  and  who  had 
had,  so  to  speak,  no  communications  with  our  troops,  were  attacked 
first,  and  most  violently.  Thus  the  choleraic  influence  was  developed 
spontaneously  in  Turkey  and  the  Crimea,  where  our  troops  have  been 
much  exposed  to  bad  hygienic  conditions.  Such  at  least  appear  to  be 
the  facts  demonstrated." 


130  THE   CRIMEAN    WAR. 

uniformly  happened  when  the  army  was  in  a  peculiarly 
critical  position,  and  suffering  from  the  influence  of 
extraordinary  depression,  want,  privations,  and  fatigues. 
The  specific  remedy  for  cholera  is  yet  to  be  discovered ; 
but  medical  science  is  not  powerless:  it  gives  wise 
preventive  measures,  which  are  but  too  rarely  ob- 
served, and  knows  the  symptoms  indicating  the  approach 
of  the  disease.  An  indisposition  with  tendency  to  chills, 
a  general  feeling  of  illness,  and  above  all,  a  derange- 
ment of  the  bowels,  with  diarrhoea,  are  the  premonitory 
symptoms,  of  which  we  should  take  careful  note  in 
times  when  cholera  is  to  be  apprehended.*  By  taking 
immediate  care  we  are  almost  sure  to  escape  the  disease, 
or  to  reduce  it  to  a  mild  form.  Cases  of  fearful  sudden- 
ness, without  premonitions,  are  so  rare,  that,  in  the 
opinion  of  many  physicians,  they  do  not  exist  at  all. 

*  All  army  surgeons  have  felt  the  difficulty  of  reaching  the 
early  stages  of  disease  among  the  privates  of  the  regiment.  Habitu- 
ally careless  of  his  health,  the  soldier  will  disregard  the  early  premo- 
nitions of  an  epidemic,  and  the  sanitary  precautions  necessary  to  avoid 
an  attack.  It  is  only  by  a  strict  enforcement  of  wholesome  regula- 
tions, and  a  constant  watchfulness  of  the  police  of  the  camp,  that  men 
will  be  prevented  from  practices  injurious  to  the  health,  and  of  immi- 
nent danger.  Diarrhoea,  as  an  accompaniment  of  cholera,  or  rather  as 
a  premonitory  symptom,  has  been  generally  remarked.  The  disease  is 
attended  with  a  depressing  effect  upon  the  human  system.  In  the 
official  medical  and  surgical  history  of  the  British  army  in  the  Crimea, 
the  following  statements  were  made  illustrating  these  facts. 

"  It  was  noticed  by  medical  officers  generally,  that  from  the  date 
cholera  first  appeared  among  the  troops  in  Bulgaria,  the  soldier's  effi- 
ciency was  greatly  impaired ;  he  was  no  longer  able  to  undergo  the 
same  exertion,  he  was  fatigued  by  short  marches,  and  a  parade,  pro- 
tracted for  a  few  hours,  left  him  exhausted  by  the  weight  of  his  accou- 
trements, and  exposure  to  the  hot  sun ;  and  when  the  army  arrived 
in  the  Crimea,  it  was  evident  that  the  physical  capabilities  had  already 
been  sadly  reduced.  In  short  marches — though  it  must  be  admitted 
generally  marches  very  protracted — the  men  fell  out  of  the  ranks  in 
great  numbers ;  they  were  unable,  in  many  instances,  to  carry  their 
burdens,  and  their  canteens,  and  even  blankets,  in  some  cases,  were 
thrown  away.  This  mysterious  poison,  so  subtle  as  to  traverse  immea- 
surable distances,  riding  on  the  air,  so  gross  as  to  find  conveyance  in 
moving  battalions,  across  water,  over  hills  and  valleys,  and,  if  neces- 
sary, through  climates  of  opposite  characteristics,  was  at  work  ;  and 
the  exhausting  flux  which  it  determined,  drained  off  the  manly  ener- 
gies of  the  soldier,  sapped  his  strength,  and  rendered  him,  in  many 
instances,  helpless  as  a  child." — TR. 


THE    CRIMEAN   WAK.  131 

The  measures  to  be  taken  are  very  simple,  such  as 
placing  in  a  bed,  so  as  to  facilitate  a  salutary  perspira- 
tion— warm  aromatic  infusions — a  girdle  of  flannel 
around  the  bowels,  and  attention  to  diet.  Light  at- 
tacks of  the  disease  require  no  other  treatment.  In 
the  cold  stage  it  is  chiefly  necessary  to  restore  the 
heat  and  circulation,  and  we  must  have  recourse  to 
warm  aromatic  drinks,  with  a  few  drops  of  ether. 
Rough  frictions  over  the  body,  sinapisms  upon  the  ex- 
tremities, warm  flannel  coverings,  and  bottles  of  warm 
water  applied  to  the  body,  are  usually  considered  useful 
measures.  Shampooing  (massages)  and  friction  excite 
the  capillary  circulation,  and  recall  the  heat  to  the  cold 
parts,  as  after  submersion ;  yet  some  physicians  doubt 
their  efficiency.  In  fact,  it  seems  doubtful  whether 
purely  mechanical  agencies  can  combat  successfully  a 
refrigeration  caused  by  a  depression  of  the  vital  forces. 
Turkish  baths  exert  a  remarkable  influence,  and  M. 
Cazalas  derived  excellent  results  from  their  use  in  the 
hospitals  of  Constantinople.  These  remedies  could  not, 
of  course,  be  used  to  any  extent  in  the  Dobrutcha. 
The  inadequacy  of  the  stimulant  allowed  the  pulse  and 
animal  heat  to  fall  almost  to  complete  depression,  and 
many  of  the  sick  died  without  any  reaction. 

These  excitants,  if  pressed  too  far,  have  their  danger, 
as  they  may  hasten  the  reaction  of  fluxes  and  visceral 
congestions,  which  may  prove  fatal.  We  therefore  find 
ourselves  placed  between  two  evils — too  little  and  too 
much.  The  appearance  of  reaction  is  an  almost  infalli- 
ble indication  of  returning  health,  if  rightly  managed. 
Bleeding,  and  acidulous  drinks,  modify  its  violence. 
Convalescence  demands  the  greatest  caution,  as  relapses 
are  always  very  serious  in  results.  It  will  be  seen  that 
this  treatment  is  easy  to  apply ;  it  is  rational  and  simple, 
and  in  fact  too  simple  to  satisfy  the  sick,  who  are  not 
always  contented  with  common  remedies. 

Cholera  is  transmitted  by  the  air,  and  is  not  conta- 
gious in  the  exact  sense  of  the  word;  or  otherwise,  all 
our  physicians  would  have  been  attacked.  In  its  journeys 
it  has  two  different  modes  of  travelling :  sometimes 
from  neighborhood  to  neighborhood,  and  sometimes  it 


132  THE   CRIMEAN   WAR. 

advances  by  leaping  over  a  district  where  the  inhabitants 
appeared  to  be  threatened,  and  invades,  on  a  sudden 
and  without  notice,  other  places  where  it  was  least  ex- 
pected. In  these  latter  cases  it  is  probably  imported ; 
but  whether  imported  or  not,  wherever  causes  of  affini- 
ty pre-exist,  no  matter  what  sanitary  precautions  are 
taken,  its  visit  is  certain  ;  in  like  manner  it  may  disap- 
pear spontaneously  without  our  knowing  why.  When 
circumstances  favoring  its  appearance  do  not  exist,  it 
may  be  imported  without  danger ;  it  will  not  develop 
itself.  During  the  war  of  the  East  there  was  not,  so 
to  speak,  a  single  week  in  which  choleraic  patients  were 
not  brought  in  steamboats  to  Constantinople,  but  yet 
the  disease  did  not  attack  the  Mahomedan  population. 

The  excellent  traditions  of  the  army  of  Africa  were 
not  forgotten.  They  go  back  to  the  time  of  Marshal 
Bugeaud,  who  exhibited  an  example  of  rare  solicitude 
for  the  soldier.  When  he  commanded  an  expedition,  he 
always  took  care  in  the  evening  to  reconnoitre  the  route 
of  the  morrow,  and  learn  the  obstacles  which  were  to 
be  encountered,  with  the  view  of  regulating  the  times 
of  departure  of  the  regiments,  and  never  let  the  men 
remain  a  needless  time  with  the  knapsacks  upon  their 
backs.  The  columns  started  at  daybreak  at  every  sea- 
son of  the  year,  after  taking  coffee  or  eating  soup ; 
every  man  had  a  light  infusion  of  coffee  in  his  canteen. 
After  marching  three-quarters  of  an  hour,  he  always 
called  a  halt  of  twenty  minutes,  and  after  that  they  stop- 
ped to  rest  only  a  few  minutes  at  a  time,  every  hour. 
He  presided  himself  at  the  passage  of  the  fords,  re- 
quiring the  men  to  take  off,  or  roll  up,  their  pantaloons, 
and  to  preserve  from  wet  their  shoes  and  socks.  If  the 
water  was  deep,  they  passed  over  single  file,  with  ropes 
to  serve  as  guards.  Sentinels  were  placed  over  the 
springs  of  fresh  water,  found  upon  the  road,  to  prevent 
the  troops  from  drinking  to  their  injury,  and  thus 
many  cases  of  sickness  were  avoided.  When  not  de- 
layed by  the  firing  of  the  enemy,  the  troops  reached 
their  bivouac  by  ten  o'clock  in  the  morning.  They  had 
then  time  enough  to  get  well  established,  prepare  a 
comfortable  soup,  wash  their  linen,  and  recover  from 


THE    CRIMEAN   WAE.  133 

their  fatigues.  The  camping  grounds  were  chosen,  as 
far  as  practicable,  upon  elevated  grounds,  at  a  distance 
from  swamps,  and  near  wood  and  water.  When  wood 
was  not  expected  in  the  next  bivouac,  each  soldier  car- 
ried a  faggot  upon  his  knapsack,  and  a  piece  of  wood 
used  as  a  walking  stick. 

The  Marshal  often  tasted  the  soups  of  the  messes,  and 
assured  himself  that  the  flannel  girdle  was  around  the 
loins,  and  not  in  the  knapsack.  At  nightfall  he  posted 
the  pickets  and  camp  guards,  and  to  prevent  thieves 
from  stealing  into  the  camp  by  night,  he  placed  the 
most  distant  sentries  along  the  roads,  and  those  near  the 
camp  in  the  bushes,  knowing  that  thieves  abandon  the 
regular  roads  when  they  approach  the  bivouac.  He  was 
the  last  to  retire  to  his  tent,  having  a  company  en- 
camped close  to  him,  so  as  always  to  have  some  soldiers 
at  hand,  in  case  of  an  alarm  or  night  attack.  He  was 
annoyed  whenever  he  saw  needless  fatigues  imposed  upon 
the  men  during  a  campaign,  such  as  parades,  manoeu- 
vres, dressing  line,  etc.  Said  the  Duke  of  Isly  to  a 
young  colonel  who,  on  arriving  at  the  bivouac,  had  left 
his  men  ten  minutes  under  arms,  "  I  see,  sir,  that  you 
have  never  carried  a  knapsack  upon  your  own  shoul- 
ders.'' Although  he  admitted  into  his  intimacy  the 
chief  physician  of  his  field  hospitals,  he  wished  to  ob- 
serve for  himself  the  sanitary  condition  of  his  men,  as 
to  their  digestion,  and  took  a  glance  at  their  alvine 
evacuations  around  the  camp.  He  checked  a  tendency 
to  disease  whenever  he  saw  it,  by  a  day  of  timely 
repose,  and  a  supplementary  ration  of  rice,  meat,  coffee, 
or  wine.  Knowing  that  half  of  the  troops  that  en- 
tered the  hospitals,  or  lagged  behind,  ran  the  risk  of 
losing  their  lives,  and  that  often  the  men  were  made 
lame  and  disabled  by  a  shoe  that  was  too  tight,  he 
ordered  the  colonels  never  to  allow  a  pair  of  shoes  to 
be  given  out,  until  they  had  been  carefully  tried  on : 
and  to  frequently  make  themselves  sure  of  the  con- 
dition of  the  shoes  themselves,  and  see  that  they  were 
daily  softened  by  a  coat  of  grease.  Following  the 
example  of  Marshal  Clausel,  he  assigned  a  company  of 
men  to  the  service  of  the  field  hospitals,  to  prepare  the 


134  THE   CRIMEAN   WAR. 

tents,  and  provide  wood  and  water.  He  often  visited 
the  sick  and  wounded,  and  his  presence  restored  their 
morale.  For  all  these  cares  he  was  called  the  father  of 
the  soldiers,  and  he  always  found  his  troops,  in  time  of 
combat,  energetic  and  full  of  health,  enthusiasm,  ardor, 
and  warlike  courage.  He  could  ask  of  them  the  dis- 
arming of  the  most  ferocious  tribes,  the  only  means,  in 
the  eyes  of  the  illustrious  Marshal,  of  securing  their 
submission,  and  the  empire  to  our  arms. 

The  painful  impression  made  by  the  expedition  of  the 
Dobrutcha,  was  rapidly  effaced.  The  allied  armies  em- 
barked for  the  Crimea,  to  enter  upon  the  real  campaign, 
in  which  battles  and  new  diseases  soon  rendered  the 
establishment  of  many  new  hospitals  necessary.  From 
1854  to  1856,  nineteen  French  hospitals  were  success- 
ively established  at  Constantinople,  in  buildings  of  four 
different  kinds  :  permanent  barracks,  Turkish  hospitals, 
palaces,  and  wooden  barracks.  To  recall  the  circum- 
stances which  caused  the  establishment  of  these  hospi- 
tals would  be  to  record  the  most  melancholy  epochs  of 
the  campaign. 


CHAPTER   TI. 
THE   HOSPITALS   AT   CONSTANTINOPLE. 

ON  the  14th  of  September,  1854,  the  three  allied 
fleets  disembarked,  without  resistance,  upon  the  soil  of 
the  Crimea,  at  Oldfort,  137  cannon  and  61,200  men  ;  of 
whom  27,000  were  French,  an  equal  number  English, 
and  6,000  Turks.  The  want  of  good  drinking  water, 
which  would  have  to  be  brought  a  distance  of  three  miles 
and  a  half,  compelled  the  allied  armies  to  use  a  brack- 
ish water,  obtained  by  digging  pits  along  the  sea  shore  ; 
but  this  became  so  bitter  when  it  was  boiled  that  they 
abandoned  it  in  making  soups.  They  were  also  without 
wood.  The  consequences  were,  derangements  in  the 
digestive  organs,  which  brought  on  some  of  the  symp- 
toms of  cholera,  especially  in  the  English  army.  Our 


THE   CRIMEAN   WAR.  135 

allies,  having  been  unable  to  bring  their  large  tents, 
which  were  inconvenient  to  carry,  were  furthermore 
exposed  by  night  to  dampness  and  the  abundant  rains, 
while  our  African  army  had  with  them  their  little  shel- 
ter-tents. 

On  the  19th  an  order  to  advance  was  hailed  with  a 
shout  of  enthusiasm.  The  divisions  were  doubly  happy 
in  marching  upon  the  enemy,  and  in  leaving  these  bivou- 
acs, destitute  as  they  were  of  wood  and  water.  We 
know  with  what  vigor  and  success  the  Russians  were 
attacked,  on  the  morrow,  in  their  formidable  posts  at 
Alma ;  upon  their  left,  by  the  troops  under  General 
Bosquet,  whom  nothing  checked,  neither  canister  nor 
the  ruggedness  of  rocks  ;  upon  their  right,  by  a  portion 
of  the  valiant  English  army;  and  in  the  centre  by  the 
bayonet  charges  of  the  troops  of  Generals  Canrobert  and 
Napoleon. 

The  transportation  of  the  wounded  upon  cacolets,  and 
litters  borne  upon  the  backs  of  mules,  again  demon- 
strates that  this  system  is  better  than  ambulances  upon 
wheels.*  Whenever  a  man  fell  wounded  in  the  ranks 
his  comrades  carried  him  a  few  paces  in  the  rear,  where 
the  muleteers  took  charge  of  him.  The  battalion  sur- 
geon, or  those  who  attended  the  ambulance,  applied  the 
first  dressings  and  made  him  lie  down  in  a  litter,  or  sit 
in  a  kind  of  chair  called  the  cacolet,  in  which  he  was 
then  carried  to  the  field  hospitals,  placed  as  well  as  might 
be  out  of  the  reach  of  the  bullets.  There  each  officer 
and  soldier  waited  his  turn  to  be  operated  upon,  except 
that  those  more  severely  wounded  took  precedence. 

The  victory  achieved  on  the  20th  of  September, 
poured  into  our  field  hospitals  1,033  wounded  French 

*  In  1835,  in  the  expedition  of  Mascara,  in  the  province  of  Oran,  I 
realized  the  idea  of  carrying  litters  upon  camels,  one  upon  each  side. 
This  method  has  since  been  perfected.  The  camel,  in  walking,  has  a 
balancing  motion,  and  the  wounded  were  placed  rather  high.  We 
have  exchanged,  with  advantage,  the  camel  for  the  mule,  an  animal 
more  gentle  and  more  easily  managed. — AUTHOR'S  NOTE. 

The  Cacokt  consists  of  a  pair  of  chairs  with  strong  side  arms  and 
concave  backs,  which  hook  together  and  hang  across  a  mule.  The 
seats  are  attached  to  the  backs  by  hinges  and  straps,  so  as  to  be 
adjusted  to  the  most  convenient  angle  for  the  patient. — TR.  . 


136  THE  CRIMEAN   WAR. 

and  several  hundred  Russians.  Both  were,  immediately 
after  the  first  dressings,  carried  on  board  the  fleet,  and 
thence  to  Constantinople,  where,  on  the  24th  of  Septem- 
ber, was  established  the  hospital  of  Dolma-Baktche, 
located  about  one  hundred  rods  from  the  Bosphorus. 
This  hospital,  reserved  almost  entirely  for  the  wounded, 
embraced  two  isolated  and  entirely  distinct  buildings ; 
the  one  more  elevated  was  the  artillery  hospital  of  the 
Ottoman  Guard,  and  the  other,  about  twenty  rods  below, 
contained  600  beds.  The  ships  arriving  from  the  Crimea, 
anchored  at  the  entrance  of  the  Golden  Horn  near  Top- 
Hana.  The  wounded,  placed  upon  tenders  and  landed 
at  Dolma-Baktche,  were  carried  upon  litters  by  attend- 
ants or  Turkish  soldiers.  From  September  24th,  1854, 
to  April  1st,  1856,  this  hospital  received  8,582  invalids, 
mostly  wounded ;  and  of  these  2,318  died.  The  manage- 
ment of  this  important  service  was  intrusted  to  a  skilful 
director,  Dr.  Salleron. 

The  officers  wounded  at  Alma,  caused  the  establish- 
ment of  the  hospital  of  Canlidje  upon  the  Asiatic  side 
and  directly  adjacent  to  the  Bosphorus.  The  viceroy 
of  Egypt  had  liberally  placed  at  our  disposal  this  domain, 
which  was  his  country  residence.  Beautiful  undulating 
gardens,  a  pure  atmosphere,  and  elegant  kiosques,  made 
this  an  enchanting  place  of  sojourn.  Near  us  was  the 
palace  of  Fuad-Pacha,  minister  of  foreign  affairs.  Two 
young  Armenian  girls,  belonging  to  his  harem,  eluded 
the  vigilance  of  the  eunuchs.  Their  songs  and  playing 
upon  the  piano  had  attracted  the  notice  of  two  aides- 
major,  whom  they  saw  through  the  lattice  of  their  win- 
dows. They  were  smitten  with  their  admirers,  and  one 
fine  day  escaped  in  the  costume  of  one  of  the  pacha's 
sons.  On  the  next  day  they  were  taken  back  to  their 
prison.  This  escapade  would  have  assumed  the  propor- 
tions of  a  grave  event,  had  it  not  been  for  the  prudence 
of  Fuad-Pacha,  who  contented  himself  with  recovering 
the  fugitives.  It  was,  nevertheless,  asserted — wrongly,  I 
have  no  doubt — that  according  to  the  Turkish  custom, 
these  two  unfortunates  were  put  into  a  sack  and  cast 
into  the  Bosphorus.  Subsequently  the  wounded  officers 
exchanged  the  hospital  of  Canlidje  for  the  house  of  the 


THE   CKIMEAN   WAE.  137 

Russian  ambassador.  Two  or  three  hundred  beds, 
placed  in  the  palace  of  Mehemmed-Ali,  were  appro- 
priated to  the  soldiers. 

It  wTill  be  remembered  that  the  allied  armies  landed  in 
the  Crimea  with  nothing  but  light  artillery,  which  was 
quite  unable  to  contend  against  the  heavy  marine  artil- 
lery which  bombarded  them  from  the  roadstead  of  Sebas- 
topol.  It  was  necessary  to  prepare  for  a  regular  siege. 
The  wrorks  of  investment  and  circumvallation  were  begun 
on  the  9th  of  October,  and  rapidly  pushed  forward; 
numerous  battalions  and  companies  of  sharpshooters 
protected  the  laborers.  Night  and  day  one  half  of  the 
army  were  exposed  to  the  iron  storm  and  the  vicissi- 
tudes of  the  season,  while  the  other  half  snatched  a  short 
repose  in  order  to  take  its  turn  at  the  work.  New 
troops  arriving  daily  increased  the  number  of  the  sick, 
while  the  failure  of  the  fire,  opened  October  17th,  1854, 
against  the  place,  by  the  vessels  of  the  two  combined 
fleets,  and  by  batteries  mounting  126  siege  guns, -added 
new  numbers  to  our  wounded,  and  seemed  to  indicate 
that  the  city  of  Sebastopol,then  defended  by  a  garrison 
of  32,000  men,*  and  by  the  army  of  reserve  under  the 
orders  of  Prince  Menchikoff,  could  not  be  taken  by  a  sud- 
den dash.  The  remittances  of  sick  and  wounded  from  the 
Crimea  to  Constantinople,  followed  one  another  rapidly. 
In  October  two  important  hospitals  were  opened,  one 
'  for  1,200  sick  at  Ramis-Tchiflik,  a  fine  barrack  situated 
upon  the  plains  of  Daoud-Pacha ;  and  the  other  upon  the 
heights  which  command  the  Bosphorus  towards  Pera, 
in  the  buildings  of  the  preparatory  school,  which  were 
arranged  to  receive  400  beds.  In  the  following  months 
new  hospitals  were  opened.  In  the  extensive  gardens 
of  the  point  of  the  old  seraglio,  at  Gulhane,  the  military 
engineers  had  erected  barracks  for  1,800  sick ;  above 
that,  the  University  palace,  a  fine  edifice  of  cut  stone, 
and  still  unfinished,  was  prepared  as  a  hospital  for  1,400 
beds. 

These  twro  establishments,  opened  in  the  old  aristo- 
cratic Ottoman  quarter,  in  the  very  heart  of  Stamboul, 

*  Of  whom  21,000  were  marines,  rendered  available  in  the  sinking 
of  the  vessels  to  serve  as  a  barrier  to  the  roadstead. 

7* 


138  THE   CRIMEAN   WAR. 

denoted  to  what  degree  of  tolerance  the  Turks  had 
attained  concerning  us.  In  the  suburb  of  Pera,  there 
were  added  to  the  hospitals  already  established  there, 
that  of  the  Military  School,  containing  one  thousand  one 
hundred  beds,  reduced  soon  after  to  five  hundred  by  a 
fire,  and  that  of  the  Parade  Ground,  containing  twelve 
hundred  beds  under  shelters.  The  barrack  of  Daoud- 
Pacha,  designed  as  a  place  for  convalescents,  became 
itself  a  hospital  for  one  thousand  two  hundred  sick. 
With  such  vast  resources  for  hospital  accommodation 
yet  barrack-camps  for  twenty-five  thousand  men  were 
being  constructed  at  Muslak,  on  the  high  plateaux 
which  border  the  shores  of  the  Bosphorus,  and  proved 
of  incalculable  service  in  time  of  the  typhus.  The 
central  pharmaceutical  department,  intrusted  to  supply 
the  medical  service  of  the  Crimea,  and  of  Constantinople, 
was  established  upon  the  sea-shore,  near  Bachisstach,  in 
the  palace  of  a  pacha.  The  Minister  of  War  had  sent 
to  the  army  of  the  East,  new  and  complete  material  for 
thirty-five  hospital  establishments  of  five  hundred  beds 
each.  I  have  spoken  before  of  the  difficulties  encoun- 
tered in  the  Crimea,  in  taking  care  of  the  materials,  and 
in  washing  the  bed  clothing  and  the  linen.  We  were 
surprised  to  find  these  difficulties  at  Constantinople. 
To  surmount  them,  it  was  only  necessary  to  establish 
small  steam  wash-houses,  like  those  which  some  military 
hospitals  possess,  as,  for  example,  that  of  Nancy.  For 
this  purpose,  a  movable  furnace  containing  a  steam 
generator  is  necessary.  The  steam  entering  at  the  base 
of  the  double-bottomed  coppers,  acts  mechanically  upon 
the  linen,  impregnated  with  an  alkaline  solution,  and 
hastens  the  formation  of  soap-suds.  Without  going  into 
further  details  of  the  operation  of  this  economical  appa- 
ratus, easy  to  set  up  and  transport,  I  would  add,  that  it 
only  requires  four  hours  to  empty  a  copper  of  three  and 
a  quarter  tons,  and  eight  hours  by  the  method  of 
Thiery,  to  empty  four  coppers  at  once.  How  useful 
these  washing  machines  would  have  been,  not  only  in 
our  hospitals,  but  in  our  field-hospitals,  and  even  in  our 
stationary  camps. 

About  two-thirds  of  the  fever  patients  received  into 


THE   CRIMEAN   WAR.  139 

the  hospitals  of  Constantinople,  were  attacked  by 
diarrhoea  or  dysentery.  The  diarrhoea  was  so  common, 
that  we  might  say  that  sickness  was  almost  always 
preceded  by  a  diarrhoea  in  the  acute  stage,  and  termi- 
nated by  a  diarrhoea  in  the  chronic  stage.  This  sad 
complication  was  not  peculiar  to  the  army  of  the  East, 
but  has  been  observed  in  all  armies  in  campaign  ;  it  is 
concomitant  with  the  soldier's  life,  to  the  poor  rations, 
home-sickness,  and  the  thousand  influences  which  it  is 
not  always  possible  to  foresee.  Dysentery  has  almost 
always  for  its  first  symptom,  a  more  or  less  active 
diarrhoea,  of  which  it  is,  as  it  were,  the  second  stage. 
The  intestinal  changes  proceeding  even  to  ulceration, 
indicate  alike  the  anatomical  lesion  in  the  two  diseases. 
Acute  diarrhoea,  so  common  among  soldiers  upon 
beginning  a  campaign,  is  often  cured  in  a  few  days 
by  rest,  regimen,  the  wearing  of  a  flannel  girdle,  and  if 
needed  a  few  drops  of  laudanum.*  If  it  were  possible  to 
treat  it  always  by  these  simple  means,  and  to  prevent 
relapse  by  hygienic  care,  we  might  certainly  reduce  by 
more  than  half  the  number  of  cases  of  disease,  and  of 
death.  An  emetic,  or  an  emetico-cathartic,  will  almost 
always  drive  off  in  a  short  the  gastric  difficulties  with 
which  this  disease  becomes  complicated.  In  the  chronic 
or  advanced  stage,  astringents,  which  are  so  much  extolled, 
only  give  an  ephemeral  rather  than  a  real  relief,  and  are 
often  more  pernicious  than  useful.  The  best  tonic  is 
good  wine,  in  small  doses  often  repeated,  the  effect  of 
which  should  be  carefully  watched  by  the  physician. 

*  Feculent,  gummy,  arid  sweetened  drinks,  are  almost  always  given 
in  intestinal  disorders,  as  emollients.  In  a  very  interesting  work  upon 
antiphlogistic  and  emollient  medication,  by  Prof.  S.  Delioux  de  Roche- 
fort,  he  has  examined  the  action  of  these  so  called  emollients.  He 
concludes  that,  feculent,  gummy,  and  sweetened  drinks,  being  soon 
decomposed  and  absorbed  upon  entering  the  intestines,  their  emollient 
topical  application  is  null,  unless  we  consider  them  as  nutritious 
drinks,  perhaps  useful  in  so  far  as  they  make  agreeable  change  in 
the  diet  of  the  sick.  In  a  word,  they  are  aliments,  not  medicines. 
These  views  appear  to  justify  the  practice  of  the  English  physicians, 
who  are  as  sparing  of  diet-drinks  as  we  are  prodigal  of  them  in 
France.  It  is  true  that  our  sick  believe  they  cannot  be  cured  unless1 
they  take  infusions  of  all  kinds,  which  harm  oftener  than  they 
benefit. 


140  THE    CRIMEAN   WAK. 

A  light  dose  of  opium  alone,  or  better  still,  given  with 
ipecacuanha,  or  sulphate  of  magnesia  in  small  doses,  has 
been  more  efficacious  than  all  other  therapeutic  agents. 
A  severe  regimen  can  alone  prevent  a  relapse,  which  is 
very  often  fatal.* 

This  disorder  would  have  committed  greater  ravages, 
had  it  not  been  for  the  moral  energy  which  through  the 
whole  campaign  sustained  the  French  troops,  and  which 
never  showed  itself  so  strongly  as  in  the  most  critical 
moments. 


*  Diseases  of  the  bowels,  the  constant  scourge  of  armies,  affected  the 
English  troops  to  an  alarming  extent  in  the  Crimean  war.  For  one- 
third  of  the  eighteen  months  embraced,  they  presented  a  more  fatal 
aspect  than  had  ever  before  been  recorded.  The  exciting  causes 
might  be  divided  into  two  great  classes. — First,  an  epidemic  or  choleraic 
constitution  of  the  air,  with  the  seasoning  agencies  of  a  hot  climate, 
and  2d,  the  hardships  and  privations  of  a  winter  siege,  in  an  inhospi- 
table climate.  The  mortality  was  chiefly  to  be  ascribed  to  the  latter 
class  of  causes.  From  April,  1854,  to  June,  1856,  inclusive,  55,767 
cases  of  diseases  of  the  stomach  and  bowels  were  admitted  into 
the  English  hospitals,  of  which  7,611  were  from  the  cavalry,  7,014 
from  the  ordnance,  and  41,140  from  the  foot  guards  and  infantry. 
Of  these,  5,950  were  fatal;  281  from  the  cavalry,  487  from  the 
ordnance,  and  5,182  from  the  foot  guards  and  infantry. 

The  scorbutic  taint  gave  peculiar  virulence  to  this  class  of  diseases, 
and  the  prevalence  of  ulceration  of  the  intestines,  especially  towards 
the  lower  part,  was  perhaps  the  most  constant  pathological  condition 
observed.  Surgeon  Macleod  remarks  upon  this  condition  as  follows  : 

"  The  immense  majority  of  those  who  served  during  the  early  part 
of  the  war  were  so  affected,  the  ulceration  being  rather  of  recent  than 
ancient  date :  and  this  remark  does  not  apply  to  those  who  died  of 
abdominal  affections,  but  also  to  those  who  succumbed  from  other 
diseases  or  from  wounds.  It  is  also  a  fact  which  I  have  had  many 
opportunities  of  verifying,  that  men  killed  in  action  at  a  time  when 
they  were  apparently  in  the  possession  of  health,  or  rather,  as  it  should 
be  put,  men  dying  shortly  after  receiving  severe  wounds  when  seem- 
ingly robust,  were  found  to  have  ulcers  in  their  intestines,  sometimes 
of  a  very  extensive  character.  To  this  it  was  not  uncommon  to  find 
diseased  kidneys  and  lungs  added.  The  disease,  in  these  cases, 
might  not  be  active  at  the  period  of  death,  but  it  was  ready  to  break 
out  whenever  any  injury  or  operation  made  an  extra  demand  on  the 
powers  of  life.  It  is  of  importance  to  note  this  extraordinary  pre- 
valence of  undeveloped  disease — this  deceptive  character  in  the 
appearance  of  the  men — as  bearing  on  their  behavior  under  acci- 
dent"—TB. 


THE   CRIMEAN   WAE.  141 

The  importance  of  the  MalakofF  bastion  was  fully 
recognised,  and  preparations  for  its  attack  were  pressed 
with  vigor.  The  Russians  had  executed  with  rapidity 
a  series  of  works  and  counter-approaches,  which  it 
was  resolved  to  take  on  the  night  of  February  23-24, 
1855.  General  Bosquet  passed  through  the  trenches 
where  the  soldiers  were  half  leg  deep  in  mud.  He  was 
preparing  his  troops  for  the  combat,  when  he  met  a  sen- 
tinel, who  had  just  before  been  wounded  in  the  head,  and 
who  presented  arms.  Seeing  the  blood  flowing  from 
the  wound,  the  general  asked  him  why  he  did  not  go  to 
the  field  hospital.  "  My  shoes  are  full  of  holes,"  replied 
he,  alluding  to  the  avidity  with  which  his  comrades  dis- 
puted for  some  of  the  Russian  spoils  ;  "  there  is  to  be  a 
distribution  of  boots  to-night,  and  I  want  to  be  there." 

It  was  not  cholera  and  dysentery  alone  that  peopled 
our  hospitals  of  the  East,  but  fevers  of  various  kinds. 
The  miasms  exhaled  from  the  putrid  decomposition  of 
vegetable  matter  taint  the  air,  and  produce  in  the 
economy  the  same  effects  as  poison,  which  nature 
seemed  to  seek  to  rid  herself  of  by  critical  and  periodical 
fevers.  This  special  fever,  which  we  have  named  inter- 
mittent, to  distinguish  it  from  continued  fever  deter- 
mined by  other  causes,  is  characterized  by  three  wrell 
marked  periods  ;  first  the  cold  stage,  then  the  hot,  and 
lastly  the  sweating  stage.  However,  it  rarely  showed 
itself  in  the  Crimea  in  this  pure  and  distinct  form ;  but 
commonly  the  accession  was  incomplete — the  heat  would 
steal  on  without  the  initial  chill,  and  without  being  fol- 
lowed by  the  sweating.  This  disease  appeared  to  be  no 
other  than  a  modification  of  continued  fever.  It  was 
very  rare  to  find  diseases,  of  themselves  continuous,  run 
through  all  their  phases,  without  becoming  complicated 
with  intermittent  phenomena.  The  fevers  were  then 
generally  remittent.  They  are  thus  called  when  they 
are  composed  of  a  continuous  febrile  element  and  of  an 
intermittent  febrile  element.* 

*  The  tendency  of  malaria  to  give  a  remittent  form  to  all  diseases 
that  may  appear  in  a  given  district  where  this  influence  prevails  has 
been  often  noticed. 


142  THE    CRIMEAN   WAR. 

The  Russian  physicians  regarded  remittent  fever  as 
endemic  in  the  Crimea,  where  the  Tartars  contracted  it  as 
readily  as  strangers.  This  malady  has  been  considerably 
developed  in  their  army,  and  they  principally  attribute 
it  to  the  insalubrity  of  their  subterranean  huts.  Among 
our  soldiers  the  accessions  of  remittent  fever  were  rarely 
complete.  The  slightest  intermittent  attack  proved 
rapidly  fatal  when  it  appeared  in  the  course  of  a  con- 
tinued fever,  for  the  economy  had  then  already  received 
serious  damage  from  privations,  diarrhoea,  scurvy,  and 
other  chronic  diseases.  In  these  complicated  cases,  in 
which  the  intermittent  was  only  secondary,  the  first 
care  was  to  attack  the  continued  febrile  element  by 
emetics  if  there  appeared  a  gastric  difficulty,  by  bleed- 
ings if  symptoms  of  plethora  were  noticed,  &c.  At  the 
same  time,  upon  the  first  appearance  of  intermission  or 
remission,  it  was  necessary  to  hasten  or  prevent  their 
return  by  two  or  three  doses  of  quinine,*  of  from  fifteen 
to  thirty  grains.  The  attacks  of  pernicious  intermittent 

The  surgeons  of  the  American  army  in  winter  quarters  near  Wash- 
ington, in  the  winter  of  1861-2,  observed  this  tendency  in  nearly  all 
their  diseases,  and  derived  a  corresponding  benefit  from  the  use  of 
quinine. 

The  whole  of  the  region  occupied  by  the  army  of  the  Potomac  was 
more  or  less  malarious,  and  autumnal  intermittents  are  familiar  to  the 
civil  practitioner.  In  some  of  the  more  sickly  of  the  regiments,  the 
low  condition  of  health  might  fairly  be  traced  to  the  depressing  effects 
of  summer  camps  in  low  valleys,  which  left  the  men  with  constitutions 
impaired,  and  liable  to  the  invasion  of  diseases.  These  usually  assumed 
a  typhoid  form.  The  percentage  of  sickness  to  the  effective  strength 
varied  from  one-third  of  one  per  cent,  to  eighteen  per  cent,  in  a  regi- 
ment, the  average  being  about  five  and  a  half.  Some  of  the  sicklier 
regiments  were  from  the  Northern  border  of  the  Union ;  and  it  was 
observed  that  soldiers  enlisted  in  the  naval  districts,  although  often  a 
rough  and  apparently  hardy  class  of  men,  endured  the  open  winter  and 
humid  climate  of  the  Potomac  region  with  less  resistance  than  those 
from  cities. 

The  army  of  the  Potomac,  abundantly  fed  and  clothed,  presented 
a  favorable  comparison  with  the  British  army  in  time  of  peace,  in 
which  six  and  a  half  per  cent,  of  the  force  otherwise  available  are 
reported  "  in  hospital."  In  the  Peninsular  War  under  the  Duke  of 
Wellington,  in  1808-14,  it  was  twenty-one  per  cent.,  and  their  sick 
list  varied  from  nine  to  thirty-three  per  cent,  at  different  periods — TR. 

*  The  sulphate  of  quinine  is  always  to  be  understood  by  this  term 
when  used  in  this  work. — TR. 


THE    CRIMEAN   WAR.  143 

fever  are  caused  by  a  deep  paludal  intoxication.  In  the 
Dobrutcha  a  certain  number  of  cases  were  observed,  but 
it  was  rare  in  the  Crimea. 

The  still  increasing  numbers  of  our  fever  patients  ren- 
dered the  hospitals  at  _  Constantinople  insufficient  for 
their  accommodation.  The  Sultan,  with  an  unprompted 
generosity,  offered  a  palace  then  scarcely  finished,  which 
bore  his  name,  and  became  thenceforth  the  hospital  of 
Pera.  The  architecture  of  this  palace  was  in  the  orien- 
tal style,  very  handsome,  and  of  great  solidity.  Each 
angle  had  a  tower  which  supported  another  story,  and 
a  central  minaret,  adorned  with  many  ranges  of  balco- 
nies, boldly  pierced  the  clear  azure  of  the  heavens,  and 
lent  to  this  monument  an  aerial  appearance,  without 
detracting  from  its  majestic  character.  The  ground 
floor,  elevated  about  six  and  a  half  feet  above  the  earth, 
and  the  first  story,  presented  broad  and  immense  galle- 
ries, lighted  on  the  side  of  the  court  by  arched  openings, 
the  arches  resting  upon  elegant  pillars.  The  openings 
were  closed  by  large  windows.  These  galleries  were 
intended  to  serve  exclusively  for  promenades  in  bad 
weather,  and  it  is  to  be  regretted  that  the  necessity  of 
lodging  2,000  sick  required  us  to  employ  this  space. 
We  have  already  noticed  the  danger  of  collecting  large 
numbers  of  men  afflicted  with  severe  maladies  and  forced 
to  remain  all  the  time  in  bed.  It  is  offering  a  premium 
for  infection,  which  is  the  cause  of  the  greatest  number 
of  deaths.  Abundant  water,  of  good  quality,  was  drawn 
from  the  fine  forests  of  Belgrade,  where  visitors  admire 
the  gigantic  aqueducts  of  Constantine,  and  the  still  more 
wonderful  sluices,  which  are  held  in  place  by  enormous 
blocks  of  marble,  brought  thither  at  great  cost  in  the 
reign  of  the  Sultan  Mahmoud.  In  front  of  the  hospital 
of  Pera  rise  the  shores  of  Asia,  the  city  of  Scutari,  and 
its  deeply  ravined  knoll,  which  descends  to  the  Bospho- 
rus  and  commands  the  great  Field  of  the  Dead,  planted 
with  evergreen  trees.  The  sick  arriving  from  the  Crimea 
were  debarked  at  Bachistach,  distant  about  a  mile  and  a 
quarter  from  the  hospital,  but  the  ascent  was  so^steep 
that  convalescents  themselves  could  scarcely  make  the 
journey  on  foot.  At  the  head  of  this  great  establish- 


144  THE   CRIMEAN   WAR.  . 

ment,  the  renowned  physicians,  Messrs.  Scoutetten, 
Morgues,  and  Cambay,  were  successively  placed.  Each 
of  them  sought  to  reduce  the  figure  of  hospital  inmates, 
but  still  the  beds  were  always  full.  The  Crimea  sent  us 
new  sick  daily ;  every  ship  brought  two  or  three  hun- 
dred. It  may  give  some  idea  of  the  importance  of  the 
hospital  of  Pera  by  mentioning  that  it  received  27,500 
sick  during  the  twenty-two  months  of  its  existence,  of 
whom  9,460  left  entirely  cured,  13,000  were  sent 
to  France  or  turned  into  other  hospitals,  and  5,040 
died. 

After  the  taking  of  the  Malakoff  bastion,  the  hospital 
received  800  sick  in  one  day,  of  whom  595  were  severely 
wounded  Russian  prisoners.  The  greater  part  of  the 
latter  would  not  at  first  consent  to  the  grave  opera- 
tions which  their  condition  demanded ;  it  was  only  later, 
upon  seeing  their  comrades  die,  that  they  consented. 
Unhappily,  this  delay  was  fatal ;  but,  nevertheless,  they 
survived  in  greater  numbers  than  our  own  soldiers, 
because  their  constitutions  were  less  deeply  impaired  by 
fatigue  and  privations.  Moreover,  a  rough  and  chiefly 
manual  education,  strict  sobriety,  and  a  coarse  but  abun- 
dant aliment,  caused  a  great  preponderance  of  the  mus- 
cular system*  in  the  physique  of  the  Russian  soldier ;  the 
nervous  element  being  much  less  developed,  they  suffer 
less  in  operations  than  our  own  soldiers.  The  progress 
of  their  wounds  is  more  rapid  and  regular,  the  febrile 
reaction  less  marked ;  their  power  of  assimilating  food 
greater,  and  requiring  greater  quantities;  their  blood 
appeared  richer  and  more  plastic,  and  their  arterial  sys- 
tem more  fully  developed — so  much  so,  that  after  each 
operation  it  \vas  necessary  to  tie  more  arteries  than  in 
the  wounded  of  our  own  army.  They  evinced  strong 
tokens  of  gratitude  towards  the  French  surgeons,  who 

*  The  experience  of  the  army  surgeons  of  the  United  States  among 
our  "Western  Indians  has  led  to  a  somewhat  similar  remark.  The  repa- 
rative  forces  of  nature  appear  to  be  more  powerful  than  with  the  whites, 
and  they  will  survive  a  greater  bodily  mutilation.  This  has  been 
ascribed  by  Dr.  Day  to  the  greater  simplicity  of  their  diet,  and  may  be 
in  part  due  to  a  less  delicate  susceptibility  and  the  greater  develop- 
ment of  the  muscular  as  compared  with  the  nervous  system. — TR. 


THE   CRIMEAN   WAR.  145 

bestowed  the  same  care  upon  them  as  upon  our  own 
soldiers,  among  whom  they  lodged.  None  sought  to 
escape.  Our  rations  of  white  bread,  more  easy  of  diges- 
tion than  the  Russian  army  bread,  proved  insufficient, 
and  had  to  be  increased.  These  soldiers  wore  pictures 
of  the  saints,  or  copper  crosses,  suspended  around  the 
neck  by  a  tape ;  they  recited  daily  their  prayers  in  their 
beds,  taking  no  notice  of  the  persons  in  the  room. 

From  the  21st  of  May,  1853,  the  house  of  the  Russian 
ambassador  at  Pera  remained  closed.  On  that  date 
Prince  Menchikoff  hastily  took  his  departure.  Whilst 
the  French  and  Russian  officers  and  soldiers  encumbered 
onr  hospitals  at  Constantinople,  the  doors  of  the  palace 
remained  inexorably  closed,  although  it  was  of  size  suffi- 
cient to  receive  400  sick.  A  force  of  30,000  men,  22,000 
of  whom  were  of  the  guard,  were  assembled  in  the  fields 
of  Maslak,  to  reinforce  the  army  in  the  Crimea.  They 
experienced  many  attacks  of  cholera,  which  threw  many 
new  sick  upon  our  hospitals.  At  length,  after  the  nume- 
rous and  bloody  conflicts  of  April  and  of  May  1st,  1855 
— after  the  grand  and  terrible  artillery  duel,  which 
gained  us  some  important  works  of  defence,  it  was 
decided  to  lodge  the  French  and  Russian  wounded 
officers  in  the  house  of  the  ambassador.  All  the  furni- 
ture was  carefully  carried  into  rooms  reserved  for  its 
storage.  M.  Lelouis,  the  physician  in  chief,  a  man  of 
unquestionable  merit,  took  charge  of  the  wounded,  and 
devoted  himself  to  them,  but  still  this  hospital  soon 
showed  signs  of  infection.  The  wounded  became  affected 
with  hospital  gangrene,  and  afterwards  the  typhus, 
imported  from  the  Crimea,  was  propagated  from  bed  to 
bed.  When  peace  was  signed,  the  French  government 
expended  large  sums  in  putting  this  palace  in  good  con- 
dition, and  made  it  even  finer  than  before,  by  repairing 
injuries  of  older  date. 

At  the  beginning  of  the  campaign,  the  Sisters  of 
Charity  had  opened,  in  the  suburb  of  Pera,  a  hospital, 
which  soon  became  highly  sought  for  by  the  officers. 
Each  invalid  received,  in  a  room  by  himself,  the  most  ten- 
der and  intelligent  care,  and  could  enjoy  the  services  of 
any  military  surgeon  he  should  choose.  This  eonveni- 


146  THE    CRIMEAN    WAR. 

ence  was  very  highly  appreciated,  and  the  hospital  of 
the  Sisters  was  always  full. 

Among  the  French  soldiers  received  into  the  hospitals 
at  Pera,  there  were  many  who  had  been  wounded  in  the 
frequent  street  quarrels  of  this  suburb,  whose  mixed 
population,  so  different  from  that  of  the  Musulman 
quarter  of  the  Stamboul,  embraced  a  great  number  of 
renegades  from  justice,  of  every  nation.  At  Pera,  crimes 
were  committed  with  impunity  in  open  day  ;  assassina- 
tions occurred  in  the  middle  of  the  street,  and  the 
passer-by  went  on  his  way,  as  if  he  had  seen  nothing. 
By  request  of  the  general  of  division,  Larchey,  superior 
commandant  at  Constantinople,  the  JYench  ambassador, 
M.  Thouvenel,  obtained  permission  to  establish  a  French 
police  at  Pera,  and  our  armed  police  guards  rendered 
the  most  essential  service.  They  arrested  the  malefac- 
tors; but  here  a  new  difficulty  was  encountered,  for 
these  miserable  wretches  were  reclaimed  by  the  consuls 
of  their  country,  who,  under  the  pretext  of  trying  them, 
allowed  them  their  liberty.  It  generally  ended  by 
granting  them  a  hearing,  and  by  their  giving  a  sufficient 
security  for  good  behavior. 

At  the  time  when  the  house  of  the  Russian  ambassa- 
dor at  Pera  was  turned  into  a  hospital,  the  most  bloody 
conflicts  of  the  campaign  had  occurred,  and  some 
months  after,  the  taking  of  Sebastopol  seemed  to  put 
an  end  to  the  Crimean  war;  but  the  task  of  our  medical 
staff  was  far  from  being  ended,  and  if  the  numbers  of 
our  wounded  were  less,  those  of  the  sick  were  largely 
increased,  under  the  double  influence  of  scurvy  and 
typhus,  and  in  proportions  which  excited  the  greatest 
solicitude.  Then,  as  at  the  opening  of  the  campaign, 
the  Turkish  government  showed  itself  most  kindly  dis- 
posed to  second  the  efforts  of  the  French  administration. 
Contrary  to  all  antecedents,  the  Sultan  had  attended  a 
sumptuous  ball  given  by  the  French  ambassador.  The 
French  and  Ottoman  troops  fraternally  formed  the 
double  lines  upon  his  passage ;  salvos  of  artillery  an- 
nounced his  entrance  into  the  palace  of  the  ambassador. 
Abdul-Medjid  was  conducted  into  an  elegant  saloon, 
reserved  for  his  use,  where  I  had  the  honor  of  being 


THE   CRIMEAN   WAE.  147 

presented  to  him.  He  spoke  to  me  with  lively  interest, 
of  the  body  of  Turkish  troops  which  I  had  visited  at 
Eupatoria,  of  the  health  of  his  soldiers  and  ours,  and 
pressed  me  to  visit  the  Turkish  military  hospital  at 
Constantinople,  concerning  which  he  desired  my  opinion. 
The  Sultan  understood  French,  and  spoke  it  in  its 
purity,  but  with  a  timid  reserve,  so  that  his  minister  of 
foreign  affairs,  Fuad-Pacha,  who  had  made  medical 
studies  in  Paris,  hastened  to  supply  the  words  to  his 
thought  when  he  hesitated.  His  countenance,  naturally 
somewhat  sad  and  thoughtful,  was  animated  in  conver- 
sation, and  showed  at  times  a  remarkable  expression 
of  ingenuousness  and  benevolence.  He  made  his  en- 
trance into  the  ball,  in  the  midst  of  all  the  high  func- 
tionaries of  his  empire,  covered  with  embroideries  in 
gold,  and  crosses  in  brilliants.  His  costume  was  of  a  rich 
plainness :  a  cap  of  red  felt  without  ornament,  a  little 
black  cloak  with  upright  collar,  sparkling  with  large 
diamonds,  a  European  coat,  and  the  broad  band  of  the 
Legion  of  Honor.  The  old  Turk  party  was  greatly 
troubled  on  this  occasion  ;  in  their  alarm  they  thought 
that  the  Sultan,  in  accepting  the  broad  band  of  the 
Legion  of  Honor,  had  been  converted  to  Christianity ; 
but  to  quiet  them,  they  were  made  to  understand  that 
the  star  of  the  Legion  of  Honor  was  composed  of  five 
points,  and  not  of  four,  as  in  the  Christian  emblem. 

The  Sultan  advanced  with  slow  and  measured  steps 
into  the  ball-room,  looking  to  the  right  and  left  with  a 
tranquil  and  easy  air,  although  it  was  the  first  time  he 
had  been  in  such  an  assembly.  He  took  his  place  upon 
a  reserved  seat,  where  he  appeared  to  follow  with  some 
interest  the  movements  of  the  dance.  I  know  not 
what  impression  Abdul-Medjid  received  from  this  array 
of  beautiful  women  and  brilliant  toilets,  but  I  doubt  if 
it  was  favorable  to  female  emancipation  in  Turkey.  He 
retired  at  an  early  hour,  with  the  same  ceremonial.  I 
remarked  that  the  assistants  kept  some  distance  from 
his  person,  and  I  learn  that  this  is  not  simply  from  respect, 
but  on  account  of  the  aversion  which  contact  with  a  man 
inspires,  and  which  is  explained  by  remembering  the 
disastrous  epidemic  so  common  in  the  East.  The  Sultan 


148  THE   CRIMEAN   WAE. 

lays  off,  never  to  resume,  the  garments  which  a  man  has 
touched.  We  know  that  he  is  served  exclusively  by  the 
females  of  his  harem.  He  never  addresses  a  word  to 
any  one  in  public ;  but  once  or  twice,  to  the  great 
astonishment  of  Musulmans,  he  laid  aside  this  traditional 
habit,  in  favor  of  General  Larchey.  He  fixes  his  looks, 
for  a  longer  or  shorter  time,  upon  the  person  whom  he 
meets,  according  to  the  degree  of  esteem  which  he 
wishes  to  evince.  In  this  mute  language  of  the  padishah, 
are  foreshadowed  the  inner  sentiments  which  words  fail 
to  express.  I  was  able  to  read  it  perfectly,  during  the 
filing  of  the  high  functionaries  of  the  empire  before  the 
Sultan,  on  the  day  of  the  ceremony  of  the  beiram,  or 
kissing  the  feet.  The  filing  past  continued  more  than 
an  hour,  during  which  the  looks  of  Abdul-Medjid  did 
not  rest  upon  more  than  twenty  persons.  I  observed 
that  they  made  only  a  feint  of  kissing  the  feet,  and  each 
time  that  an  indiscreet  worshipper  touched  the  Sultan,  a 
slight  motion  testified  to  •  the  keen  and  disagreeable 
sensation  which  had  troubled  the  reverie  of  his  sove- 
reign. 


CHAPTER    III. 

THE    SCURVY    AND   TYPHUS. 

THE  leisure  which  marked  for  us  the  beginning  of 
winter  in  1856,  was  short.  The  attention  of  the  medi- 
cal corps  was  soon  called,  as  I  have  said,  to  two  grave 
epidemics — scurvy  and  the  typhus,  which  came  upon  us 
with  cruel  intensity. 

In  the  Crimea  as  elsewhere,  the  scurvy  was  induced 
by  debilitating  causes,  a  diet  too  uniform,  composed 
often  of  salted  meat,  and  a  slender  supply  of  fresh  vege- 
tables, personal  filthiness,  fatigue,  home-sickness,  putrid 
emanations,  and  above  all  a  cold,  damp,  and  rigorous 
winter.  The  first  stage  of  the  scurvy  is  marked  by  a 
change  in  the  constitution  of  the  blood,  but  without  any 
very  apparent  external  or  local  symptoms.  A  general 


THE   CRIMEAN   WAR.  149 

tendency  to  haemorrhages,  great  muscular  lassitude, 
deep-seated  pains,  especially  towards  the  feet  (pains 
which  physicians  have  mistaken  for  a  specific  disease, 
calling  it  acrodynia*),  a  slackening  of  the  pulse,  a  loss  of 
appetite,  a  marked  discoloration  of  the  skin,  and  a 
remarkable  dilatation  of  the  pupils,  these  are  the  symp- 
toms of  the  first  stage  of  this  disease.  Soldiers  were 
rarely  sent  to  the  hospital  during  this  stage,  but  almost 
all  of  those  received  for  other  diseases,  had  at  the  same 
time  scurvy  in  the  first  stage.  In  the  second  stage, 
the  gums  swelled,  softened,  and  ulcerated,  emitting  an 
infectious  and  abominable  odor.  A  sister  of  charity 
died  of  gangrenous  inflammation  of  the  pharynx,  from 
having  inhaled  the  breath  of  a  scorbutic  patient,  while 
touching  the  ulcerated  gums  with  a  pencil  wet  in  hydro- 
chloric acid.  The  teeth  become  loose,  and  more  pro- 
minent ;  the  lower  extremities  infiltrated,  present  livid 
spots,  extensive  bloody  effusions,  especially  in  the 
internal  parts,  extensive  serous  engorgement.  The 
muscles,  losing  their  elasticity,  become  hard,  like  wood, 
and  the  patient  can  no  longer  walk.  In  the  third  stage, 
the  greyish  ulcers  of  the  gums  extend  to  other  parts  of 
the  mouth,  sometimes  perforating  the  cheeks,  in  the 
form  of  gangrenous  spots,  of  which  the  parotid  glands 
were  the  principal  seat.  They  entirely  consumed  the 
tonsils,  and  caused  caries  of  the  maxillary  bones.  Hae- 
morrhages occurred  from  the  mouth,  nose,  urinary 
passages,  and  the  intestines,  the  pulse  became  extremely 
feeble,  and  the  falling  away  and  softening  of  the  tissues 
continued,  until  the  serous  scorbutic  cachexy  usually 

*  From  the  Greek  words  aKpn$  extremity,  and  oSwr]  pain.  This  name 
was  applied  to  an  epidemic  disease  which  prevailed  in  Paris  in  1828 
and  1829,  and  of  which  the  prominent  symptoms  were  a  painful  for- 
mication usually  felt  in  the  feet  and  hands. — AUTHOR'S  NOTE. 

This  affection,  like  the  "burning  feet"  noticed  among  the  sepoys  of 
India,  has  been  by  some  writers  looked  upon  as  a  sequel  of  rheumatism. 
The  Parisian  disease  was  described  as  attended  with  formication  of 
the  feet  and  hands,  streaking  along  the  edges,  a  varying  degree  of 
sensibility,  an  oedema,  dark  patches  on  the  limbs,  desquamation  of  the 
epidermis,  lancinating  pains,  and  great  heat  on  the  parts  at  night.  In 
severe  cases,  delirium,  inflammation,  paralysis,  marasmus,  and  death 
followed. — TR. 


150  THE   CRIMEAN   WAR. 

ended  by  distinct  asphyxia,  following  the  swelling  of 
the  glottis  and  epiglottis,  preventing  the  air  from 
reaching  the  lungs.  Often  congestions  form  in  the 
viscera,  which  were  found  after  death,  infiltrated  with 
discolored  and  very  impoverished  blood. 

Scurvy  prevails  as  an  epidemic,  and  is  rarely  found 
without  being  complicated  with  chronic  diarrhoea,  inter- 
mittent or  remittent  fever,  bronchitis,  pneumonia,  or 
other  diseases,  which  more  directly  cause  the  mortality 
attributed  to  scurvy.  The  treatment  throughout,  should 
be  hygienic,  rather  than  therapeutic.  In  leaving  the 
Crimea,  the  scorbutics  escaped  the  predisposing  causes. 
At  Constantinople,  and  especially  in  France,  a  diet  of 
fresh  vegetables,  timely  adopted,  almost  always  sufficed 
to  operate  a  cure,  when  the  disease  was  simple,  and  with- 
out complications. 

The  English  army  escaped  scurvy  in  1856,  from  which 
it  had  suffered  so  greatly  the  preceding  year.*  As  to 
the  Russians,  they  were,  according  to  their  army  sur- 
geons, but  lightly  affected  by  it,  and  they  attribute  this 
almost  complete  immunity  to  the  daily  distribution  of 
cabbage  and  fresh  meat.  When  the  war  was  declared, 
Russian  families  had  sent  from  every  point  of  the  em- 
pire, under  the  name  of  a  national  gift,  arabas  loaded 
with  wheat,  and  drawn  by  oxen.  This  patriotism 
relieved  and  powerfully  seconded  the  efforts  of  the 
Czar  for  provisioning  his  armies. 

*  The  English  suffered  less  from  the  scurvy  in  well  defined  forms, 
than  from  the  scorbutic  taint,  which  was  wide-spread  and  complicated 
with  other  diseases,  especially  fever,  and  affections  of  the  bowels. 
For  the  first  six  months  of  the  siege,  all  morbid  action  in  the  older 
residents  was  more  or  less  distinctly  marked  by  scorbutic  symp- 
toms. It  was  much  more  prevalent  among  the  infantry  than  in  the 
ordnance  and  cavalry  branches  of  the  service.  This  disproportion  was 
observed  chiefly  in  the  winter  of  1857,  when  the  privations  and  suf- 
ferings of  that  arm  were  greater  than  in  the  others.  All  the  facts 
observed,  only  confirmed  the  truths  previously  established,  that 
defective  innutritious  diet,  improper  shelter  and  accommodation,  over- 
crowding and  filth,  as  distinct  from  excessive  labor  and  fatigue,  were 
the  essential  causes  of  this  disease.  The  English,  in  the  Crimea,  had 
1,763  cases  of  scurvy  admitted  from  the  infantry,  of  whom  172  died. 
From  the  Ordnance  105,  and  from  the  Cavalry  223  were  received, 
and  from  each  of  these,  three  died. — TR. 


THE   CRIMEAN   WAR.  151 

F  The  Ottoman  troops  encamped  at  Eupatoria,  sent 
monthly  to  Varna  a  thousand  scorbutic  patients,  mostly 
those  gravely  affected.  A  short  sojourn  in  a  place 
where  fresh  vegetables  abounded,  re-established  their 
health.  To  apply  this  sovereign  remedy  to  the  scorbu- 
tics of  our  army,  it  was  only  necessary  to  find  some  neigh- 
boring island  in  the  Archipelago,  and  to  obtain  per- 
mission to  occupy  it.  Mytilene  appeared  to  unite  the 
necessary  conditions,  and  on  the  1st  day  of  December, 
1855, 1  went  thither  with  Messrs.  DeCourville,  a  captain 
of  engineers,  and  Quesnoy,  major  physician,  upon  the 
steamer  IlAjaccio,  attached  solely  to  the  personal 
service  of  the  French  ambassador,  and  which  M.  Thou- 
venel  placed  at  my  command.  M.  Laurent,  the  captain 
of  the  vessel,  notwithstanding  the  foul  weather,  brought 
us  to  the  island  in  thirty-six  hours.  The  French  con- 
sul, M.  Didier,  procured  us  horses  led  by  cavas,  or 
couriers.  These  cavas  follow  the  rider,  and  are  never 
far  from  him,  whatever  may  be  the  pace  of  the  horse. 
I  was  pained  at  seeing  my  cavas  run  by  my  side  over 
the  rocky  roads,  and  hoping  to  leave  him  behind, 
rushed  on  at  full  speed,  but  was  surprised  to  see  him 
arrive  before  me,  ready  to  hold  the  stirrup,  and  to 
assist  me  in  alighting. 

Mytilene,  one  of  the  largest  islands  of  the  Archipelago, 
is  the  ancient  Lesbos,  so  famous  for  its  wines  and  its 
courtesans.  It  is  about  half  way  between  Smyrna  and 
the  Dardanelles,  triangular  in  form,  the  angles  termi- 
nate by  Cape  Mativa  on  the  north,  Cape  Sigri  on  the 
west,  and  Cape  St.  Mary  on  the  east,  and  its  circum- 
ference is  about  one  hundred  and  twenty  miles,  eighteen 
miles  in  length  by  thirty-six  in  breadth.  The  soil  is 
very  sloping,  and  free  from  marshes.  The  highest 
mountains  are  on  the  west  side  of  the  island.  Mount 
Ordinus  may  be  seen  at  a  distance  from  forty-five  to 
sixty  miles ;  and  Mount  St.  Elias,  at  the  eastern  end,  and 
south  side,  forms  a  high  plateau,  crowned  by  Mount 
Olympus,  having  a  height  of  three  thousand  and  eighty 
feet.  Besides  sundry  anchorages,  the  island  has  three 
good  harbors  on  the  southern  side,  of  which  Port 
Langan  is  the  largest,  Port  Sigri,  and  lastly  Port  Olivier, 


152  THE   CRIMEAN   WAK. 

one  of  the  most  important  in  the  Archipelago.  Port 
Olivier  is  only  five  miles  from  the  city  of  Mytilene,  and 
extends  eighteen  miles  into  the  land,  with  a  breadth  of 
nearly  four  miles.  It  is  entirely  shut  in  by  high  moun- 
tains, from  the  violence  of  the  winds.  The  olive  trees 
with  which  the  heights  are  crowned,  give  a  magnificent 
effect,  and  from  these  the  port  derives  its  name.  This 
port  might  easily  contain  a  fleet  of  a  hundred  vessels.  It 
must  be  entered  by  a  south  wind,  and  can  only  be  left 
when  the  wind  is  north ;  but  steam  tugs  would  relieve 
this  difficulty.  The  mountains  on  the  west  are  covered 
with  pines  and  fir-trees  of  large  size,  whose  timber 
furnishes  materials  to  the  ship-yards  for  construction  of 
large  vessels.  A  dozen  pretty  villages  are  perched  on 
the  gentle  swell  of  the  mountains.  At  the  head  of  the 
bay,  there  exists  an  establishment  of  thermal  waters, 
slightly  saline,  and  of  86°  F.,  called  Quindros,  having 
two  large  marble  pools,  sufficient  to  accommodate  a 
hundred  bathers.  These  waters,  which  enjoy  a  great 
celebrity  in  that  region,  could  be  used  by  our  sick ; 
they  would  doubtless  prove  very  beneficial  in  the  indu- 
rations and  pains  in  the  limbs  left  by  the  scurvy. 

The  Sultan  collects  one  tenth  the  value  of  all  the  pro- 
ducts of  the  island.  Mytilene,  in  1850,  exported  three 
hundred  thousand  quintals  of  olive  oil,  but  the  severe 
winter  of  1851  injured  the  trees,  so  that  the  production 
Avas  temporarily  reduced  to  one  hundred  thousand 
quintals.  The  island  has  numerous  mulberry  planta- 
tions, and  exports  annually  about  twenty-two  thousand 
pounds  of  silk.  Its  production  of  wheat  is  insufficient 
for  the  islanders ;  it  has  many  sheep,  and  their  meat, 
which  is  excellent,  sells  at  about  five  and  a  half  cents 
the  pound,  and  the  wool  at  five  and  a  quarter  cents  the 
pound.  Cattle  are  kept  for  labor ;  and  those  used  for 
food,  are  imported  from  Asia,  whose  coast  is  but  ten 
miles  distant.  The  horses  are  very  small,  and  resemble 
those  of  Corsica.  Cow's  milk  is  rare,  but  that  of  the 
goat  is  abundant  during  ten  months  of  the  year,  and 
from  this  they  make  excellent  cheese.  Fresh  vegetables 
are  abundant,  and  of  very  low  price.  I  have  seen 
cabbages  sold  for  a  cent,  which  in  the  Crimea  would 


THE   CRIMEAN  WAR.  153 

have  cost  fifty  cents.  The  potatoes  are  of  good  qualit^J 
oranges  and  lemons  abound,  and  in  the  fish  markets, 
mullets,  dorads,  and  lobsters  were  plenty.  The  wine  is 
warm,  generous,  and  aromatized  with  mints,  but  this  in 
my  opinion  weakens  its  quality.  It  is  said,  that  rich 
mines  of  antimony  are  in  prospect  of  being  opened ;  fine 
quarries  of  marble,  and  even  of  mineral  coal,  discovered 
at  Policnity,  have  not  as  yet  been  worked. 

The  population  is  estimated  at  70,000  souls,  of  whom 
20,000  are  Turks,  and  of  these  10,000  to  12,000  live 
in  the  city.  The  remainder  of  the  inhabitants,  almost 
all  of  Greek  origin,  are  scattered  among  74  well- 
built  villages,  and  appear  in  easy  circumstances.  The 
climate  is  very  healthy,  soft,  and  temperate,  and  the 
orange-tree  thrives  in  the  open  fields.  Diseases  are 
rare,  and  intermittent  fever  is,  so  to  speak,  unknown. 
The  people  live*  to  an  advanced  age.  Water  is  abun- 
dant, *  and  of  excellent  quality.  Mytilene  is  so  cele- 
brated for  its  great  salubrity,  that  many  sick  from  other 
islands  in  the  Archipelago  go  thither  to  pass  the  time 
of  their  convalescence. 

A  hospital  for  convalescents  would  be  happily  placed 
in  this  favored  region.  The  city  of  Mytilene  is  com- 
manded by  a  large  citadel.  This  citadel,  built  by  the 
Genoese,  of  hewn  stone,  stands  out  like  a  promontory, 
and  its  ranges  of  batteries  rise  to  an  elevation  of  about 
260  feet  above  the  level  of  the  sea,  from  which  it 
seems  to  rise  as  a  single  mass.  This  fortress  includes 
numerous  magazines,  some  empty,  others  containing 
old  cannon  frames.  It  is  occupied  by  only  400  native 
troops.  It  would  be  easy  to  arrange  for  the  use  of 
the  sick,  some  of  the  magazines  and  uninhabited  houses 
which  the  Turks  had  built  in  1820,  as  a  means  of 
security  in  the  time  of  the  Greek  war  for  indepen- 
dence— so  as  to  accommodate  300  convalescents.  There 
were  still  other  buildings  that  might  be  taken.  Upon 
the  summit,  110  yards  in  the  rear  of  the  citadel,  was  a 
Turkish  barrack,  which  only  needed  the  walls  to  be 
whitewashed,  and  the  number  of  windows  increased. 
West  of  the  city,  in  the  midst  of  fine  culinary  gardens, 
stood  the  school  of  the  Greek  community,  with  very 


154  THE   CRIMEAN   WAR. 

Spacious  and  convenient  rooms.  The  conak  Moharem- 
Bey,  and  the  Metaxa  house,  -were  two  vast  Turkish 
palaces,  immediately  available,  and  in  perfect  preserva- 
tion. The  Pacha  himself  offered  me  the  palace  of  the 
former  governor,  but  this  was  falling  into  ruins,  and 
could  not  be  safely  inhabited.  He  also  tendered  to  me 
his  country  residence,  situated  about  six  and  a  quarter 
miles  south  of  the  city,  on  the  sea  shore,  and  adjacent 
to  a  small  landing.  In  riding  there,  along  the  shore,  I 
passed  through  a  beautiful  grove  of  olives,  in  the  midst 
of  which  was  a  cluster  of  pretty  villas.  In  short,  my 
visit  to  the  different  establishments  on  the  island  adapted 
for  hospital  use,  convinced  me  that  if  would  be  easy  at 
once  to  lodge  785  convalescents  at  Mytilene,  in  five 
buildings,  isolated,  it  is  true,  but  grouped  within  a  dis- 
tance of  500  or  600  yards.  This  subdivision,  doubtless, 
rendered  impossible  the  erection  of  a  hospital  of  conva- 
lescents, is  such  as  required  by  classic  traditions,  but 
these  traditions  do  not  appear  to  me  imperative  when  it 
concerns  convalescents,  to  whom  liberty  of  movement 
and  of  walking  in  the  open  air,  are  necessary.  It  suffices 
to  create  depots  of  convalescents,  organized  and  living 
like  the  companies  of  a  regiment.  There  might  also  be 
prepared,  at  small  expense,  two  establishments  under 
t  ents,  each  to  contain  2,000  scorbutic  patients,  one  at  the 
country-house  of  the  Bey,  and  the  other  near  the  ther- 
mal springs  of  Quindnos. 

A  learned  physician  settled  on  this  island,  M.  Bar- 
gigli,  afforded  in  this  examination  very  marked  and 
valuable  assistance.  The  governor  of  Mytilene,  Ismael 
Pacha,  said  to  me,  "Hasten,  for  the  English  have 
already  sent  a  commission  to  explore  the  island,  and 
doubtless  they  will  not  delay  coming ;"  and  he  kindly 
added,  "  I  would  rather  have  the  French  here  than  the 
English."  M.  Thouvenel,  on  his  part,  procured  permis- 
sion of  the  Sultan  to  put  our  plans  immediately  into 
effect.  M.  Darricau,  the  intendant  general,  Councillor 
of  State,  and  Director  of  the  War  Department,  wrote 
to  me  on  the  29th  of  December.  1855,  as  follows  : — "  I 
have  read  with  lively  interest  your  report  upon  the 
island  of  Mytilene.  Your  account  shows  perfectly  to 


THE    CRIMEAN   WAR.  155 

what  extent  we  may  there  form  an  establishment.  The 
Minister  has  addressed  to  General  Larchey  and  Intendant 
Angot,  instructions  to  decide  them  on  this  point.  There, 
our  soldiers,  under  a  pure  sky,  and  in  the  midst  of  the 
comforts  which  you  have  described,  may  be  able  rapidly 
to  recover  their  wasted  strength."  Unfortunately, 
delays  and  difficulties  after  the  peace  was  signed,  pre- 
vented a  hospital  and  the  encampments  from  being 
formed  at  Mytilene,  where  thousands  of  our  scorbutic 
patients  might  have  rapidly  recovered  their  health,  and 
not  have  furnished  at  a  later  period  so  large  a  contin- 
gent to  the  typhus. 

I  come  now  to  speak  of  the  second  and  most  terrible 
of  the  epidemics,  with  which  we  contended  in  1856. 
There  has  long  been  known  a  disease  which  develops 
itself  specially  among  people  crowded  together  into 
close  quarters,  and  subjected  to  miasmatic  influences. 
It  is  called  the  fever  of  camps,  jails,  ships,  and  hospi- 
tals, Hungary  fever,  Naples  fever,  and  the  contagious 
typhus  of  Mayence.  Its  principal  features  are — stupor, 
with  delirium,  an'  eruption  upon  the  surface,  and  the 
power  of  transmission  from  the  sick  to  a  person  in 
sound  and  perfect  health.  The  appearances,  during 
thirty  years,  of  this  disease,  in  the  duchy  of  Posen,  at 
Reims,  at  Philadelphia,  at  Edinburgh,  at  the  convict 
quarters  at  Toulon,  and  in  the  prisons  at  Strasbourg, 
have  happily  been  too  short  and  too  confined  to  allow 
us  to  observe  the  differences  which  distinguish  it  from 
the  typhoid  fever,  so  attentively  studied  in  our  day. 
The  typhus  of  the  Crimea  has  solved  the  question  of 
identity  or  of  non-identity  between  the  two  diseases, 
and  it  is  no  longer  possible  to  confound  them,  although 
they  have  more  than  one  bond  of  relationship,  and  an 
apparently  common  cause.*  It  is  generally  agreed  that 
typhus  originates  in  an  animal  miasmatic  intoxication, 
resulting  as  well  from  too  great  a  number  of  human 

"  *  See  the  Memoir  published  June  2.  1856,  in  the  Comptes  Rendus 
of  the  Academy  of  Sciences.  The  observations  which  I  collected  in 
that  Memoir  have  been  since  reproduced  by  writers  who  have  forgot- 
ten to  mention  where  they  found  them.  I  do  not  complain,  since 
they  have  aided  me  in  spreading  the  truth. 


150  THE   CRIMEAN   WAR. 

beings  closely  shut  up,  as  from  the  putrid  decomposition 
of  animal  matter.  Consequently  this  disease  appears  in 
vessels,  barracks,  camps,  prisons,  and  field  hospitals, 
crowded  with  the  wounded,  whose  sores  are  a  source  of 
abundant  suppuration.  It  shows  itself  in  besieged  cities, 
and  in  certain  localities  infected  by  dead  animals,  or  men 
left  without  burial.  There  is  this  distinction  between 
the  two  diseases :  Want  is  the  essential  cause  of  typhus, 
while  it  is  scarcely  an  accidental  cause  of  typhoid  fever. 
Authors  agree  on  the  non-relapse  of  typhoid  fever. 
Two  physicians,  Messrs.  Lardy  and  Laval,  were  attacked 
with  typhus,  although  they  had  four  or  five  years  before 
had  the  typhoid  fever.  There  were  found  traces  of  the 
latter  in  the  cicatrices  of  intestinal  ulcers  in  M.  Lardy, 
who,  less  fortunate  than  M.  Laval,  died.  This  is  another 
proof  of  the  non-identity  of  typhus  and  of  typhoid 
fever. 

Contagion,  still  very  much  doubted  in  the  latter,  is 
not  in  the  former.  We  have  seen,  especially  in  the 
service  of  M.  Lallemant,  major  physician,  the  typhus 
propagated  from  bed  to  bed  in  the  wards,  spreading 
itself  by  contact,  and  killing  those  sick  of  some  light 
affection.  At  another  time,  as  in  the  field  hospital  of 
the  first  division  of  the  third  corps,  the  typhus  attacked 
almost  every  hospital  employe ;  fifteen  physicians  in 
sixteen  were  attacked,  and  there  did  not  remain  a  single 
healthy  attendant.  The  word  contagion,  as  applied  to 
typhus,  ought  to  be  explained.  The  typhus,  generated 
spontaneously  by  certain  definite  causes,  does  not  trans- 
mit itself  by  the  contact  of  a  sick  person  with  one  in 
health,  but  rather  by  infection ;  that  is  to  say,  by  the 
air  charged  with  the  elements  of  typhus.  The  morbific 
miasm  exhaled  from  the  surface  of  the  sick,  or  from 
animal  detritus,  infects  the  man  who  breathes  it ;  and 
once  absorbed,  during  a  longer  or  shorter  time,  called 
the  period  of  incubation,  it  prepares  the  organism  for 
sickness. 

Typhus  differs  on  one  point  from  most  epidemic  dis- 
eases, such  as  small-pox,  scarlatina,  measles,  sweating 
sickness,  cholera,  etc.  These  are  brought  on  by  a  pre- 
disposing condition  of  the  atmosphere,  and  the  physician 


THE   CRIMEAN   WAR.  157 

has  no  means  of  preventing  their  invasion.  On  the 
contrary,  the  causes  of  typhus  are  known,  to  such  a 
degree,  that  we  can  produce  or  terminate  at  will  the 
typhic  influence.  Another  remarkable  difference  between 
typhus  and  common  epidemic  maladies,  is  that  the  latter 
have  a  regular  course  of  duration,  while  typhus  holds 
on  and  extends  its  ravages  indefinitely,  so  that  by  any 
well  directed  measures  we  cannot  master  it. 

Typhus  breaks  out  more  or  less  quickly,  according  to 
the  intensity  of  the  affection,  and  the  resistance  of  the 
organism.  Every  sick  person  sends  out  noxious  emana- 
tions. When  the  wards  are  full,  when  the  cases  of  pri- 
mary or  contracted  typhus  increase,  the  epidemic  fur- 
nace acquires  a  greater  energy,  and  its  manifestations 
radiate  through  the  entire  personnel  of  the  hospital.  It 
was  in  this  way  that  the  sisters,  the  chaplains,  the  phy- 
sicians, and  the  attendants  were  so  cruelly  struck  down 
during  the  war  of  the  East.  We  have  seen  some  physi- 
cians, less  predisposed,  endowed  with  a  greater  power 
of  reaction,  or.  of  elimination  of  the  absorbed  miasm, 
overcome  the  epidemic  influence  in  a  manner  little 
apparent,  but  still  real.  Each  time  that  the  fire  of  infec- 
tion increased  in  the  hospital  by  swelling  the  numbers 
of  the  typhic,  they  were  seized  with  headache  and 
sleeplessness,  the  tongue  was  dry,  and  the  countenance 
assumed  a  typhic  aspect.  These  symptoms  held  on 
three  or  four  days,  when  the  typhic  veil  was  torn,  and 
they  returned  to  their  usual  health.  Sometimes,  how- 
ever, the  morbid  state  continued,  and  then  the  issue 
was  almost  always  fatal. 

The  progress  of  the  typhus  in  the  Crimea  was  less 
uniform  and  regular  than  that  so  well  described  by  Hil- 
denbrand,  one  of  the  most  eminent  physicians  of  the 
Vienna  school.*  The  irregularity  of  typhus  in  the  Cri- 
mea was  due  to  various  complications,  chiefly  of  scurvy, 
dysentery,  and  intermittent  fevers.  It  was  on  the  1st  of 
January,  1856,  that  the  typhus,  which  the  year  previous 
had  commenced  to  show  itself,  was  greatly  developed. 

*  In  a  treatise  upon  contagious  typhus,  published  in  Vienna  in 
1810,  and  translated  into  French  the  next  year  by  M.  Gasc,  health 
inspector  in  the  army. 


158  THE    CRIMEAN   WAR. 

During  the  last  days  of  the  siege  of  Sebastopol,  the  hos- 
pital gangrene,  that  typhus  of  wounds,  committed  great 
ravages.  The  scurvy,  already  remarked  by  Franck  as 
the  precursor  of  typhus,  had  assumed  immense  propor- 
tions. The  contagious  typhus  waited  only  for  the  con- 
centration and  accumulation  consequent  upon  the  rigors 
of  winter,  to  break  forth.  The  soldiers  packed  into 
their  tents,  hermetically  closed,  in  which  the  ground 
was  damp  and  impregnated  with  impurities,  were 
fatally  poisoned  by  the  organic  miasm.  Moreover  the 
energetic  excitement,  so  powerful  in  resisting  typhus, 
fell  with  Sebastopol,  and  they  saw  themselves  delivered 
over  to  the  epidemic  without  relief  from  these  powerful 
moral  reactions. 

The  typhus  described  by  Hildenbrand  should  have 
shown  the  regular  character  assigned  by  that  writer,  if 
not  among  our  soldiers,  broken  down  and  already  a 
prey  to  other  maladies,  at  least  among  the  physicians, 
the  chaplains,  and  the  other  attendants  of  the  hospitals 
at  Constantinople,  whose  constitutions  were  not  broken  ; 
but  even  here  irregularity  was  the  rule,  and  the  eight 
stages  describe*  by  Hildenbrand  were  not  perhaps 
observed  in  a  single  case.  The  premonitory  state  (lassi- 
tude, unrefreshing  sleep,  lumbar  pains,  shudderings, 
painful  tension  in  the  head,  and  vertigo),  so  common  in 
typhoid  fever,  were  often  wanting.  The  typhus  almost 
always  began  with  a  chill  and  an  inflammatory  period, 
which  foreshadowed — besides  the  more  or  less  distinct 
catarrhal  state  of  the  eyes,  nasal  passages,  and  bronchia 
— an  intense  frontal  headache,  dizziness  as  in  intoxication, 
stupor,  great  prostration  of  strength,  intense  thirst, 
often  a  saburral  condition  of  the  digestive  passages,  and 
a  calm  or  furious  delirium.  The  skin  became  burning, 
and  after  two  or  three  days  was  covered  with  a  kind  of 
eruption  which  was  never  absent  except  in  subjects  too 
much  broken  down,  and  which  differed  essentially  from 
that  of  typhoid  fever.  This  eruption  appeared  upon  the 
trunk  and  limbs,  in  irregular  groups  of  rounded  spots, 
of  deep  red,  not  in  relief,  smaller  in  size  than  a  bean,  not 
disappearing  upon  pressure,  and  not  of  such  a  character 
as  to  be  confounded  with  the  spots  of  typhoid  fever. 


THE   CRIMEAN    WAR.  159 

The  continuity  of  the  fever  with  100  to  130  pulsations 
to  the  minute,  was  often  broken  by  one,  or  more  rarely 
two  regular  paroxysms,  in  twenty-four  hours,  which 
much  resembled  the  accession  of  remittent  fever,  and 
gave  to  the  typhus  of  the  Crimea  a  peculiar  character. 
The  belly  was  soft,  without  pain,  or  flatulence,  or  the 
rumbling  in  the  right  iliac  fossa,  which  is  the  proper 
symptom  of  typhoid  fever.  Constipation  has  almost 
always  occurred,  in  place  of  the  intestinal  flux  of 
typhoid  fever,  when  dysentery  did  not  exist  upon  the 
invasion  of  typhus.  After  an  inflammatory  period  last- 
ing five  or  six  days,  there  supervened  a  nervous  period 
marked  by  ataxic  or  adynamic  symptoms,  and  often  by 
a  mixture  of  both.  The  nervous  period  lasted  four  or 
five  days,  and  was  but  little  observed  when  convales- 
cence began. 

The  typhus  sometimes  ran  through  these  three  periods 
with  a  fearful  rapidity,  and  death  often  supervened  the 
third  day,  and  even  the  second  or  the  first.  The  typhus 
was  then  terrible.  It  rarely  lasted  beyond  fifteen  days, 
unless  complicated  with  organic  congestions  of  one  of 
the  three  splanchnic  cavities  (the  brain,  the  chest,  and 
the  abdomen),  and  a  return  to  health  almost  always 
occurred,  if  at  all,  within  twelve  days.  The  sick  passed 
suddenly  from  death  to  life,  and  the  typhic  veil  of  the 
face  fell  off,  the  eye  became  clear  and  intelligent,  the 
appetite  ravenous,  and  strength  returned  with  great 
rapidity.  Still  the  intellect  retained  the  stigma  of 
typhus,  as  shown  by  disturbing  dreams  by  night,  or 
delirium  upon  some  points  by  day,  although  the  reason 
was  clear  on  the  others.  A  weakness  of  hearing  and 
sight,  a  more  or  less  complete  loss  of  memory  remained 
for  a  considerable  time,  nevertheless  the  hair  did  not 
fall  out  as  in  typhoid  fever.  These  favorable  changes 
were  often  preceded  by  bleeding  at  the  nose,  sweats, 
and  morbid  condition  of  the  urine,  and  sometimes 
inflammation  of  the  parotid  glands.  It  will  be  noticed 
that  convalescence,  which  is  so  slow  and  so  difficult  to 
manage  in  typhoid  fever,  proceeds  rapidly  in  typhus. 
The  departures  from  a  strict  diet  are  little  to  be  feared, 
which  is  explained  by  the  absence  of  the  lesions  of  the  intes- 


160  THE   CRIMEAN  WAE. 

tinal  follicles,  and  of  the  engorgement  of  the  mese'nteric 
glands  which  form  so  constant  and  important  a  feature 
in  typhoid  fever,  and  which  hundreds  of  post-mortem 
examinations  have  never  discovered  in  our  hospitals  of 
the  East. 

To  cure  typhus,  it  is  necessary,  above  all,  to  have 
pure  air  constantly  renewed ;  to  withdraw  the  sick  from 
the  causes  of  the  infection,  to  ventilate  the  room,  and 
order  frequent  aromatic  and  chlorine  fumigations ;  to 
respect  the  inflammatory  period  as  the  greatest  effort  of 
nature ;  to  drive  out  the  miasmatic  poison  by  an  exan- 
thematous  pressure.  Not  to  bleed  unless  the  subject  is 
very  strong;  if  threatened  with  cerebral  apoplexy,  pre- 
fer generally  leeches  behind  the  ears,  or  cups  between 
the  shoulders  to  a  general  bleeding,  a  remedy  of  which 
we  should  be  extremely  cautious.  Adopt  the  same 
means  when  the  smallness  of  the  pulse  denotes  an 
oppression  of  the  vital  forces,  which  are  relieved  by 
moderate  sanguineous  depletion.  When  from  the 
beginning,  as  in  the  typhus  of  the  Crimea,  there  were 
remittent  paroxysms,  it  was  weU  to  attack  the  disease 
with  a  few  doses  of  quinine.  By  this  means,  the  con- 
tinuity of  the  fever  was  secured,  and  it  fell  of  itself  after 
a  few  days,  unless  maintained  by  an  organic  congestion 
produced  by  its  first  attack.  This  complication  fre- 
quently occurred  when  we  did  not  take  care  to  anni- 
hilate entirely  the  paroxysms,  that  is,  the  recurrences 
of  the  fever.  On  an  attack  of  typhus  an  emeto- 
cathartic  was  useful,  especially  if  there  existed  some 
gastro-intestinal  difficulty;  we  give  mucilaginous  or  aci- 
dulated drinks,  and  sometimes  wine  in  water.  In  the 
nervous  period  we  have  recourse  to  the  remedies 
employed  in  ataxy  and  adynamia.  In  the  latter,  tonics, 
such  as  Malaga  or  port  wine,  much  hastened  recovery. 

Such  is  a  brief  statement  of  the  treatment  which 
gave  the  best  results  in  the  army  of  the  East,  and  upon 
which  the  most  experienced  physicians  relied,  such  as 
M.  Cazalas,  who  from  the  first  conceived  the  idea  of 
regulating  the  inflammatory  action  by  quinine,  by  ex- 
pelling the  paludal  element,  which  had  so  marked  an 
influence  upon  the  sickness  of  the  Crimea.  To  sum  up ; 


THE   CRIMEAN   WAR.  161 

the  typhus  reveals  its  true  nature  by  its  infectious  cha- 
racter, its  easy  communication,  the  rapidity  of  its  pro- 
gress, the  whole  train  of  its  symptoms,  and  the  absence 
of  anatomical  lesions. 

We  may  derive  still  further  light  concerning  the 
typhic  affection,  by  comparing  the  typhus  of  the  Crimea 
with  epidemics  of  the  same  kind  that  have  afflicted 
populations  and  armies,  at  other  periods.  Doubtless 
there  is  no  absolute  resemblance,  because,  as  we  know, 
epidemic  manifestations  vary  in  the  same  disease,  ac- 
cording to  the  season,  the  locality,  and  the  people,  but  we 
find  in  the  typhus  of  the  Crimea,  the  same  putridity  and 
rapid  destruction  of  the  vital  forces,  that  distinguish  the 
typhus  of  Mayence,  the  delirium,  stupor,  and  rosy 
exanthem  described  by  Hildenbrand,  etc.  If  the  typhus 
of  the  Crimea  was  not  very  grave,  as  compared  with 
the  dreadful  epidemics  of  Mayence  and  Torgau,  we 
may  explain  this  by  the  different  conditions  in  which 
we  found  our  army ;  a  better  hygiene,  the  prompt  care 
bestowed  upon  the  sick,  the  facility  and  abundance  of 
means  of  transportation,  the  multiplication  of  hospitals, 
and  lastly  to  the  moral  conditions  and  material  resources 
which  did  not  exist  in  the  campaigns  of  1812  and  1814. 

The  appearance  of  contagious  typhus  was  the  most 
terrible  event  that  happened  to  the  army  of  the  East. 
The  blow  struck  first  in  the  Crimea.  In  November, 
1855,  the  reports  made  to  me  by  M.  Scrive,  noticed  in 
that  month  11  cases  of  typhus,  of  which  6  were  fatal. 
December  showed  the  following  increase:  from  the  1st 
to  the  10th,  4  new  cases,  1  death  ;  from  the  10th  to  the 
20th,  46  new  cases,  21  deaths ;  and  from  the  20th  to 
the  31st,  92  new  cases,  41  deaths.  During  the  month, 
the  field  hospitals  of  the  Crimea  had  emptied  upon  the 
hospitals  of  Constantinople  3,206  sick.  All  of  these 
had,  in  the  field  hospitals  of  the  Crimea,  been  in  con- 
tact with  the  typhus,  had  lain  in  the  same  wards 
side  by  side.  Some  were  even  lightly  tainted  with 
typhus,  so  that  the  hospitals  of  Constantinople  began 
to  show  from  the  10th  to  the  20th  of  December,  13 
cases  and  2  deaths,  and  from  the  20th  to  the  31st, 
28  new  cases  and  7  deaths. 


162  THE  CRIMEAN  WAE. 

From  that  moment,  I  sought  to  restrain  from  the 
start,  by  an  extensive  plan,  the  first  menaces  of  this 
new  disease,  and  submitted  to  Marshal  Pelissier  a 
project  having  for  its  end  the  maintenance  until  spring, 
in  good  quarters  in  the  camps  of  Constantinople,  of  all 
the  sick  who  came  from  the  hospitals  of  the  Crimea ; 
and  likewise  of  sending  thither  several  thousand  men 
from  the  regiments,  who  were  drooping,  or  already  in 
the  regimental  infirmaries. 

"  I,  myself,  consider  the  first  project,''  the  Marshal 
replied  on  the  4th  of  January,  "  as  one  of  easy  applica- 
tion, and  as  capable  of  giving  good  results  by  allowing 
the  complete  recovery  of  men  still  weak  and  subject  to 
relapse.  Yet  I  do  not  think  we  ought  to  adopt  it  unless 
with  men  whom  the  health  officers  recognise  as  out  of 
condition  of  rendering  service,  and  whom  they  judge 
necessary  to  send  to  Constantinople  for  the  winter. 
When  these  shall  have  gained  sufficient  strength  to 
return  to  the  ranks,  they  should  rejoin  their  corps,  as  here- 
tofore. I  have  therefore  the  honor  of  informing  you, 
that  I  have  issued  orders  to  General  Larchey,  to  put 
this  measure  into  execution,  in  this  qualified  sense.  I 
have  likewise  examined  the  proposition  which  formed 
the  subject  of  your  second  note,  dated  on  the  1st  inst., 
relative  to  our  sending  to  Constantinople  the  drooping 
men  now  in  the  Crimea.  As  to  these,  its  adoption  ap- 
pears to  me  less  opportune,  on  account  of  the  great 
numbers  already  sent  off.  Those  thus  sent  away,  are 
already  a  too  active  cause  of  the  diminution  of  our 
effectives,  and  they  realize  indirectly  the  end  that  you 
propose.  I,  however,  am  perfectly  conscious  that  a  soli- 
citude for  the  well-being  of  our  soldiers  alone  prompts 
you  to  make  the  proposition,  and  I  thank  you  for  having 
done  so." 

The  4th  January,  1856,  M.  Scrive  informed  me  that 
the  health  of  the  Crimean  troops  continued  compara- 
tively satisfactory.  "  Your  prescriptions,  sir,"  he  said, 
"are  being  executed,  and  you  shall  have,  as  soon  as 
possible,  the  information  concerning  the  ambulances, 
which  you  require  to  be  supplied  from  the  heads  of  the 
department," 


THE    CRIMEAN   WAR.  163 

"  From  information  received  from  the  intendant-gene- 
ral,  I  learn  that  we  have  now  in  service  5,000  complete 
beds  in  barracks,  and  5,000  places  for  men  in  tents. 
There  are  no  troops  in  shelter  tents;  all  have  either 
camp  tents  or  huts.  The  Zouaves'  huts  answer  their 
purpose  well ;  the  rain  enters  very  little,  and  the  inge- 
nious soldier  immediately  places  a  sod  over  the  holes. 
The  large  heating  apparatus  for  Aurelle's  and  Herbillon's 
divisions  do  not  answer ;  they  have  been  inundated  by 
the  deluging  rains.  The  partially  underground  tents 
are  healthy ;  those  of  the  flying  ambulances  at  the 
Tchernaya  are  perfect  models.  The  regimental  infir- 
mary barracks  are  being  constructed,  but  not  without 
great  difficulty.  I  hope,  however,  to  have  two  ready 
for  each  regiment  in  a  few  days.  In  fact,  we  shall  soon 
be  well  provided  in  every  way." 

"It  snows  and  rains  continually.  The  sun  has  not 
shown  itself  for  a  fortnight.  In  the  face  of  such  a  severe 
winter,  the  health  of  the  troops  is  better  than  could 
have  been  anticipated." 

A  few  days  later,  M.  Scrive,  in  a  report  addressed  to 
the  Council  General  of  the  Health  of  the  Army,  said : — 
"  The  causes  which  have  produced  this  healthy  condition 
of  the  army  were  foreseen,  and  the  result  was  certain. 
Several  months  ago,  Inspector  Baudens  wrote  to  the 
Minister  of  War,  that  the  hygienic  condition  in  which 
the  army  would  be  placed  during  the  winter  would  ren- 
der sickness  more  general  and  severe.  This  prophecy 
was  unfortunately  substantiated.  Although  the  troops 
have  not  had  to  experience  the  fatigues  of  a  siege,  yet 
they  suifered  from  the  condition  of  continued  warfare 
which  followed  the  fall  of  Sebastopol.  It  was  no  longer 
a  circumscribed  circle  of  trenches,  but  a  line  of  defences, 
thirty-six  miles  in  length,  from  the  valley  of  Baidar  to 
Sebastopol,  which  had  to  be  defended.  Continual  alarms 
obliged  three-fourths  of  the  troops  to  remain  under  arms. 
This  extended  line  of  defence  rendered  numerous  pickets 
and  advance-guards  necessary;  it  made  the  furnishing 
of  provisions  difficult  and  irksome ;  and  it  was  spreafl 
over  ground  in  many  instances  unfavorable  for  winter 
camping,  but  rendered  necessary  by  war.  t  ,  ,  ." 


164  THE   CRIMEAN   WAR. 

The  hygienic  conditions  of  our  hospitals  at  Constanti- 
nople and  the  appearance  of  the  new  epidemic,  however, 
actively  engaged  the  attention  of  our  head  physicians. 
I  had  frequent  conferences  with  them,  and  visited  them 
almost  daily  during  their  rounds,  so  that  I  might  per- 
fectly understand  the  situation.  They  also  represented 
to  me,  in  writing,  the  cases  where  an  ameliorated  con- 
dition was  urgently  required. 

The  suggestions  I  had  made  to  the  Commander-in- 
Chief  brought  me,  on  the  9th  January,  1856,  the  follow- 
ing despatch  from  M.  Angot,  military  superintendant  at 
Constantinople,  relative  to  the  establishment  of  a  depot 
for  convalescents : — 

"  SIR — The  General  of  Division  commanding,  orders 
me  in  a  letter,  dated  8th  January,  to  confer  with  you, 
in  accordance  with  the  orders  of  the  Marshal  command- 
ing, respecting  the  immediate  establishment  at  Constan- 
tinople of  a  sort  of  depot  for  convalescents,  destined  for 
the  use  of  the  soldiers  now  in  the  Crimea  who  are  too 
weak  to  withstand  the  severities  of  the  winter. 

"  This  measure  being  adopted  on  your  suggestion,  I 
have  the  honor  to  request  you  to  inform  me  what  con- 
ditions of  location  you  deem  most  applicable  for  the 
immediate  establishment  of  this  depot,  as  much  with 
regard  to  the  medical  attendance  as  for  the  adoption  of 
particular  regulations,  if  such  are  required. 

"It  is  indispensable  for  me  to  know  your  opinion  on 
these  questions,  before  indicating  to  General  Larchey 
the  system  to  be  followed  in  realizing  to  the  utmost  the 
intentions  of  the  Marshal  commanding.  You  will,  per- 
haps, with  me,  recognise  the  advantage  of  a  conference, 
in  which  Dr.  Thomas  and  the  military  sub-intendants 
shall  be  asked  to  take  part.  In  this  case,  I  shall  be 
obliged  by  your  informing  me  the  day  and  hour  which 
would  be  most  convenient." 

The  llth  of  January,  a  committee,  composed  of  Gene- 
ral Larchey  (President),  of  General  Pariset,  of  Military 
Intendant  Augot,  and  inspector  Baudens;  De  Missy, 
sub-intendant ;  Lieut.-Col.  Cadart,  Chief  of  Engineers ; 
M.  Thomas,  Physician-in-Chief ;  and  having  for  its  Secre- 
tary, Lieut.  Col.  Gravillon,  Major  of  the  Staff,  was  as- 


THE   CRIMEAN   WAE.  165 

sembled  in  conference,  and  made  many  arrangements 
of  recognised  utility.     These  formed  the  basis  of  detailed11 
instructions,  to  be  found  in  the  appendix. 

Notwithstanding  the  precautions  taken,  the  typhus 
made,  both  in  the  Crimea  and  at  Constantinople,  rapid 
and  alarming  progress.  In  the  Crimea,  there  were 
counted  from  the  1st  to  the  10th  of  January,  34  new 
cases,  and  49  deaths ;  from  the  10th  to  the  20th,  164 
cases,  and  70  deaths.  In  the  same  period  at  Constanti- 
nople, there  occurred,  from  the  1st  to  the  10th,  95  new 
cases,  and  15  deaths;  from  the  10th  to  the  20th,  162 
cases,  and  32  deaths ;  and  from  the  20th  to  the  31st, 
205  cases,  and  18  deaths. 

The  epidemic  was  sadly  confirmed.  There  can  be  no 
doubt  as  to  the  cause  which  propagated  it  in  our  hospi- 
tals at  Constantinople.  It  was  the  impossibility  of  iso- 
lating the  men  tainted  with  typhus,  and  the  crowding.* 
In  a  report  made  to  me  January  29,  1856,  by  Doctor 
Garreau,  the  Physician-in-Chief  of  the  hospital  of 
Daoud-Pacha,  he  thus  relates  how  the  accumulation 
of  the  sick  in  that  hospital  kindled  suddenly  the 
typhus : 

"  At  Daoud-Pacha  we  enjoyed  very  satisfactory  sani- 
tary conditions  up  to  December  21st,  but  diseases  of  bad 
type  were  not  slow  in  appearing,  in  proportion  as  the 
sick  sent  from  the  Crimea  became  more  numerous,  espe- 
cially when  this  number  passed  certain  limits.  A  care- 

*  Physicians  and  Directors  do  not  agree  upon  the  word  crowding. 
The  latter  apply  the  definition  literally ;  so  that,  in  a  hospital  pre- 
pared, for  instance,  for  1500  sick,  they  would  not,  in  reaching  that 
number,  especially  if  each  patient  had  70  cubic  feet  of  air  to  breathe, 
be  crowded.  But  with  the  physician,  a  crowding  exists,  when  an 
increasing  mortality  reveals  the  presence  of  contamination  from  a 
collection  of  sick.  From  that  moment  he  should  advise  a  reduction 
in  number  of  patients,  and  the  disinfection  of  the  wards.  In  a  cam- 
paign, when  a  soldier  is  convalescent,  he  leaves  his  place  for  another 
more  sick  than  himself,  and  the  beds  are  never  empty  day  nor  night. 
As  each  sick  man  is  a  furnace  of  mephitic  emanations,  we  may  see 
how  an  encumbrance  may  be  rapidly  gained.  In  times  of  peace,  a 
hospital  for  1500  sick  has  scarcely  1000  beds  in  use  at  any  one  time, 
and  a  third  of  the  convalescents  walk  out  into  the  courts  and  gardens 
during  the  day,  thus  benefiting  the  remaining  sick,  by  giving  them 
the  70  cubic  feet  of  air  allowed  them  in  the  wards. 


166  THE    CRIMEAN   WAR. 

fill  observation  of  facts  demonstrates  satisfactorily,  that 
1  crowding,  in  badly  ventilated  and  poorly  lighted  wards, 
without  lires,  was  the  cause,  I  do  not  say  the  only  but 
the  principal  cause,  of  our  actual  condition. 

"On  the  21st  of  December,  we  reckoned  525  sick,  all 
doing  well.  We  had  729  beds  occupied  on  the  1st  of 
January,  and  the  sanitary  condition  was  passable,  be- 
cause the  defective  wards  were  not  as  yet  crowded. 
From  the  1st  to  the  10th  of  January,  our  number 
increased  to  877,  and  from  the  10th  to  the  20th  it 
amounted  to  1,140  scorbutic  or  diarrho3a  patients, 
almost  all  of  them  quite  debilitated.  It  was  at  exactly 
this  time,  when  it  was  necessary  to  crowd  the  beds 
together,  and  exceed  the  normal  number,  that  the 
typhus  fever  began  to  rage  in  the  hospital,  beginning,  as 
you  know,  in  the  upper  story.  Within  fifteen  days  more 
than  125  cases  of  continued  fever  were  disclosed,  the 
persons  attacked  being  almost  all  of  them  convalescents. 
About  eight  in  ten  came  from  the  Crimea.  The  sick 
were  few  on  the  llth,  more  numerous  on  the  21st  of 
January,  and  increased  rapidly  from  the  21st  to  the 
29th  ;  following  step  by  step  the  progress  of  the  crowd- 
ing in  the  wards,  for  the  sick  placed  in  the  vast  gal- 
leries, where  the  air  was  constantly  renewed,  did  well." 

The  instructions  which  the  Minister  of  War  had 
given  me  in  writing  had  anticipated  the  terrible  and 
exceptional  periods.  He  said : 

"  Independently  of  your  duty  as  inspector,  which  in- 
vests you  with  the  right  of  direct  correspondence  with 
me,  I  desire  that  the  authority  of  your  rank  as  well  as 
your  surgical  skill,  may  be  employed  for  the  benefit  of 
the  army,  and  I  hope  that  you  will  not  remain  uncon- 
scious of  the  impetus  which  might  be  given  to  the  me- 
dical service  by  your  presence  during  your  sojourn 
either  at  Constantinople  or  in  the  Crimea. 

"To  this  end,  when  you  think  it  expedient,  or  wrhen 
the  circumstances  may  require  it,  you  are  to  take  tem- 
porarily the  direction  of  the  service,  and  to  practise  as 
well  on  the  battle-field,  as  in  the  field  and  the  regular 
hospitals,  and  both  by  your  example  and  your  counsels  to 
support  our  military  physicians  in  the  heavy  task  rest- 


THE   CRIMEAN   WAR.  167 

ing  upon  them,  and  sustain  them  in  the  way  of  zeal  and 
devotion  for  the  cause  in  which  they  are  engaged. 

"  If  any  grave  diseases  should  break  out  at  one  or  many 
points  in  the  country  occupied  by  our  army,  you  will 
search  for  the  causes,  and  study  their  character,  symp- 
toms, and  progress,  suggest  the  preventive  measures 
which  circumstances  seem  to  you  to  require,  and  give  to 
the  health-officers  such  instructions  for  their  guidance 
as  may  be  proper  in  the  treatment  of  these  diseases. 

"You  will  give  to  the  general  commanding-in-chief, 
and  to  the  intendaut  general  as  well  as  to  General  Larch ey, 
and  the  intendant  of  the  station  at  Constantinople,  all 
the  information  which  they  may  ask,  and  such  advice  as 
you  may  think  fit  to  submit  to  them,  relative  to  the 
health  of  the  army,  upon  the  salubrity  of  grounds  and 
localities,  upon  the  establishment  and  organization  of 
hospitals,  field-hospitals,  etc. 

"  For  the  rest,  my  dear  sir,  I  leave  it  to  your  solicitude 
for  the  welfare  of  our  soldiers,  and  to  your  experience 
in  campaign  service,  to  supply  what  the  foregoing  in- 
structions have  left  incomplete,  and  I  feel  assured  that 
you  will  find  in  the  command  and  administration,  that 
cordial  concurrence,  which  will  render  your  mission  as 
fruitful  of  results  as  possible." 

During  the  whole  course  of  the  epidemic  I  took  the 
official  direction  of  the  health  service  in  the  army,  and 
was  thus  able  to  impart  to  it  greater  unity  and  strength. 
I  entered  then  upon  my  duties  of  Inspector,  which  placed 
me  in  a  more  elevated  sphere,  as  the  delegate  of  the 
minister. 

It  was  necessary  to  employ  energetic  measures,  with- 
out which  the  mortality  would  have  been  unlimited. 
The  principal  remedies  were  the  isolation  and  ventilation 
of  the  sick.  I  earnestly  pressed  the  military  intendant 
to  place  the  typhic  patients  in  special  wards,  where  the 
air  might  be  freely  admitted,  and  thus  at  the  same  time 
guard  the  other  sick  against  the  risk  of  infection.  It 
became  necessary  to  open  new  hospitals  in  temporary 
barracks,  to  prevent  encumbrance,  to  find  places  for 
5,000  sick,  and  to  be  able  to  lodge  four  typhic  patients 
only  in  each  barrack  in  the  camps  of  Maslak,  instead  of 


168  THE   CRIMEAN  WAR. 

eight,  as  in  common  sickness.  Our  English  allies  ten- 
dered us  every  kind  of  assistance,  both  personal  and 
material. 

General  Storks  offered  to  go,  and  prepare  in  one  of 
our  camps  a  hospital  complete  for  1000  sick,  and  to  fur- 
nish and  attend  them,  it'  we  desired  it.  "Whatever 
we  do,"  said  he,  "  we  can  never  repay  the  French,  for 
what  they  did  for  us  last  year."  Happily  we  were 
plentifully  supplied  with  materials,  and  the  military  in- 
tendant  at  once  introduced  a  salutary  change  in  the 
rations.  The  things  most  needed,  were  room  and  pure 
air,  and  I  urged  the  adoption  of  temporary  barracks. 
This  was  made  the  subject  of  several  consultations  under 
the  presidency  of  General  Larchey,  and  it  was  decided 
to  separate  the  sick,  and  to  increase  the  number  and 
extent  of  the  hospitals. 

At  the  same  time  I  was  occupied  with  devising  measures 
for  preventing  the  spread  of  the  pestilence  in  the  Crimea, 
and  on  the  llth  of  February,  1856,  I  wrote  to  Marshal 
Pelissier  and  to  the  Minister  of  War  as  follows  : 

"  Reports  from  the  Crimea  show  a  great  increase  in 
the  numbers  of  soldiers  entering  the  hospitals,  while  at 
the  same  time  diseases  are  reducing  our  number  of  phy- 
sicians. I  pray  your  Excellency  to  permit  me  to  sub- 
mit, on  this  occasion,  some  reflections  inspired  by  an 
interest  for  the  service. 

"  An  increase  of  the  sick  was  foreseen.  An  army  whose 
effective  strength  is  doubled  within  a  year,  and  which 
includes  a  great  number  of  young  soldiers,  wrould,  as  I 
have  said  in  former  reports,  send  during  the  rigors  of 
winter  large  numbers  to  the  field  hospitals.  In  view  of 
this  probable  event,  each  regimental  infirmary  received 
two  barracks,  and  6,000  mattresses  have  been  sent  to 
the  Crimea  to  replace  the  mats  upon  which  the  sick  have 
lain.  These  prudent  measures  have  nevertheless  not 
allowed  us  to  completely  dispense  with  putting  the  sick 
in  tents,  where  they  have  no  other  bed  than  a  mat,  and 
one  or  two  blankets  ;  many  have  had  their  feet  frozen, 
and  have  reached  us  from  the  Crimea  in  the  most  piti- 
able condition. 

"  I  presume  that  recourse  was  only  had  to  the  tents  in 


THE   CRIMEAN   WAR.  169 

cases  of  absolute  necessity,  and  it  is  well  to  remember 
that  this  shelter,  so  excellent  in  summer,  may  become 
very  pernicious  in  winter,  when  they  are  hermetically 
closed  to  exclude  the  cold,  and  the  air  not  being  renewed, 
becomes  loaded  with  noxious  miasms,  that  develop 
typhoid  fever,  if  not  the  typhus.  When  these  are 
opened,  the  frost  seizes  upon  the  anemic  men  within.* 

"  The  fault  of  arrangement  of  these  tents  has  been 
their  nearness  to  each  other.  They  should  not  occupy 
more  than  a  third  of  the  ground,  so  that  they  may  be 
moved  daily  when  the  weather  permits,  and  keep  at  a 
distance  from  each  other  the  hotbeds  of  infection  of 
which  they  so  soon  become  the  seat. 

"The  field-hospital  barracks,  encumbered  with  soldiers 
dangerously  sick,  are  rapidly  infected.  They  are  unfor- 
tunately much  too  near  together,  so  that  they  mutually 
radiate  upon  each  other  their  infection.  To  render 

*  Living  in  common  in  tents,  carefully  closed,  is  extremely  perni- 
cious to  the  health. 

In  this  confined  atmosphere,  vitiated  by  the  vapors  thrown  off 
from  the  breath  and  skin,  and.by  the  emanations  of  the  infected  soil, 
the  soldier  yields  to  the  effects  of  poison  by  putrid  intoxication.  "We 
know  that  confined  air  may  contain,  besides  its  constituent  elements 
(oxygen  and  nitrogen),  traces  of  the  oxyde  of  carbon,  sulphuretted 
hydrogen  and  ammonia,  and  that  it  is  besides  altered  by  an  excess  of 
carbonic  acid,  and  other  principles  called  miasms,  not  as  yet  appreci- 
able by  chemical  reagents,  but  whose  presence  is  revealed  by  their 
disastrous  effects  upon  human  health.  From  the  experiments  of  the 
savan  M.  Dumas,  it  appears,  that  an  adult  changes  into  carbonic  acid 
gas,  by  respiration,  in  one  hour,  all  the  oxygen  in  3-2  cubic  feet,  and 
that  to  supply  this  loss,  twelve  cubic  feet  of  fresh  air  are  required  per 
hour  by  each  individual. 

Carbonic  acid  gas  being  less  respirable  and  heavier  than  the  ele- 
ments of  air,  we  learn  the  danger  in  soldiers  passing  the  night  toge- 
ther, under  an  air-tight  tent,  and  lying  upon  the  ground.  If  asphyxia 
does  not  occur,  as  in  the  Grotto  del  Cane,  near  Naples,  the  aerrzation 
of  the  blood  is  impaired,  and  it  becomes  impoverished.  As  to  the 
mephitism  caused  by  organic  emanations,  it  carries  into  the  circu- 
lation a  special  poison  of  more  or  less  active  character,  of  which  the 
prolonged  effects  appears  as  typhus  in  campaigns,  and  in  times  of  peace, 
when  the  air  is  not  well  renewed  in  the  hospitals  these  influences 
result  in  other  diseases,  such  as  typhoid  fever,  scrofula,  and  consump- 
tion. According  to  some  hygienists,  the  indispensable  ration  of  pure 
air  to  each  man  is  at  least  18  cubic  feet  per  hour.  (See  Appen- 
dix.) 


170  THE   CRIMEAN   WAR. 

them  healthy,  they  should,  besides  the  measures  already 
advised,  be  fumigated  five  times  daily ;  twice  with  chlo- 
rine, at  six  o'clock  in  the  morning  and  at  seven  in  the 
evening ;  and  three  times  with  dry  sage,  after  the  cus- 
tom of  the  Turks,  who  in  their  hospitals  take  effectual 
precautions  against  contagious  diseases.  The  aromatic 
fumigations  should  be  made,  one  at  noon,  and  the  two 
others  half  an  hour  after  the  fumigations  with  chlorine. 
These  precautions  had  been  entirely  neglected,  even  in 
our  hospitals  at  Constantinople,  and  I  was  obliged  to 
enforce  them  with  vigor,  but  not  without  difficulty.  The 
regimental  infirmaries,  and  if  possible  the  tents  of  the 
soldiers,  where  the  trampled  ground  will  not  allow  of  a 
change  of  place,  should  also  be  purified  by  these  fumiga- 
tions. While  the  liberated  chlorine  decomposes  and 
neutralizes  the  miasms,  air  charged  with  aromatic  vapors, 
searches  into  the  corners  and  recesses,  and  escapes,  bear- 
ing with  it  the  sickly  odors.  They  are,  so  to  speak,  an 
atmospheric  broom. 

"  Dried  aromatic  plants  abound  in  the  markets  of  Con- 
stantinople, and  a  supply  might  easily  be  sent  from 
there  to  the  Crimea. 

"Your  Excellency  is  aware  that  the  typhoid  fever, 
and  especially  the  typhus,  makes  some  progress  before 
Sebastopol.  Thanks  to  the  measures  in  operation,  the 
latter  does  not  threaten  us  with  the  fierce  ravages  which 
it  displayed  in  1812  and  1814,  but  nothing  should  be 
omitted  in  watching  and  preventing  the  spread  of  this 
powerful  epidemic. 

"The  accumulation  of  the  sick  from  the  Crimea,  in 
our  hospitals  at  Constantinople,  operated  unfavorably 
upon  their  hygienic  condition,  in  consequence  of  the 
severity  of  the  diseases.  Commonly,  among  a  hundred 
sick,  only  ten  are  in  danger ;  but  here  the  proportions 
are  reversed,  and  in  a  hundred  tainted  men,  ninety  are 
in  a  perilous  condition.  There  are  scorbutic  patients, 
with  infected  breath,  and  dysenteric  patients  with  con- 
tagious typhic  emanations.  The  miasmatic  intoxication 
of  our  hospitals  has  developed  numerous  unlooked-for 
troubles.  To  arrest  them,  I  have  proposed  the  reopen- 
ing of  the  discontinued  hospitals,  and  the  creation  of 


THE   CKIMEAN   WAK.  1^1 

others,  sufficient  for  about  five  thousand  beds,  in  the 
camps  at  Maslak,  and  between  the  hospitals  of  Ramis- 
Tchifflick  and  Maltepe,  where  the  sick  may  be  free,  and 
in  a  salubrious  and  well-ventilated  situation. 

"  To  prove  that  to  check  typhus  it  is  only  necessary 
to  place  the  sick  in  a  non-infected  place,  we  may  refer 
to  the  depot  of  convalescents  prepared  in  a  portion  of 
the  camps  of  Maslak.  .  In  one  thousand  men,  not  one 
showed  any  traces  of  typhus ;  they  recovered  rapidly, 
and  only  fifteen  soldiers  were  sent  back  to  the  hospitals, 
and  nineteen  to  the  infirmary. 

"  Mytilene  would  have  been  a  providential  resource 
for  the  scorbutic,  on  account  of  its  fine  climate,  thermal 
waters,  and  abundance  of  fresh  vegetables. 

"  Your  Excellency  knows  that  at  Constantinople  there 
are  barracks  for  lodging  about  twenty-five  thousand 
men,  that  might  be  easily  converted  in  twenty-four 
hours,  into  good  hospitals.  These  resources  would  allow 
of  the  arrangement  providing  for  the  sick  sent  from 
the  army  in  the  Crimea,  according  to  the  views  that  I 
proposed.  The  ailing  fill  the  regimental  infirmaries ;  but 
it  would  be  better  to  send  them  directly  to  the  quarters 
prepared  fo«  their  reception,  without  their  passing 
through  the  field  hospitals,  where  their  condition  is 
aggravated. 

"The  medical  employees  in  the  places  devoted  to 
contagious  diseases  have  paid  a  large  tribute  to  the 
typhus ;  many  physicians  are  dead,  and  twenty-five,  not 
including  those  actually  sick  in  the  Crimea,  are  under 
treatment  in  the  hospital  at  the  Russian  embassy. 

*  Your  Excellency  will  observe  with  satisfaction,  that 
not  a  single  army  officer  has  shown  any  traces  of  the 
typhus,  which  proves  that  it  is,  as  it  were,  imprisoned  in 
the  hospitals,  and  is  not  propagated  in  the  camps  by 
contagion,  although  it  is  generated  spontaneously  in 
the  tents." 

M.  Larchey,  General  of  Division  and  Superior  Com- 
mandant at  Constantinople,  to  whom  I  had  imparted 
my  plan  of  converting  into  hospitals  the  camps  of  which 
I  have  spoken,  directed  me  to  prepare  some  instructions 
to  lay  before  a  commission,  which  met  February  13, 


2  THE   CRIMEAN   WAR. 

1856.  The  minutes  which  follow  repeat  very  nearly 
what  I  have  already  stated. 

Upon  the  call  of  the  General  of  Division,  the  military 
commandant — Messrs.  Pariset,  brigadier-general,  at- 
tached to  the  general  of  division ;  Angot,  military 
intendant,  upon  special  service ;  Baudens,  inspector  of 
the  health  service  of  the  army  of  the  East ;  De  Missy, 
military  sub-intendant  of  the  1st  class ;  Cadart,  lieu- 
tenant-colonel commandant  of  engineers ;  Wilson,  mili- 
tary sub-intendant  of  the  2d  class ;  Thomas,  principal 
physician  of  the  1st  class;  Demortain,  principal  apothe- 
cary of  the  2d  class — assembled  in  council  February  13, 
1856,  at  the  general  head-quarters,  for  the  purpose  of 
inquiring  into  the  measures  to  be  taken  to  prevent  the 
development  and  spread  of  typhic  diseases  in  the  mili- 
tary hospitals  of  Constantinople. 

After  full  discussion  and  inquiry  at  this  session,  the 
following  arrangements  were  adopted,  namely  : — 

1st.  The  numbers  of  sick  in  the  hospitals  are  to  be 
reduced,  until  the  miasmatic  infection  shall  have  dis- 
appeared. 

2d.  An  examination  is  to  be  made  by  the  command- 
ant of  engineers  relative  to  the  labors  jiecessary  to 
convert  into  hospitals  the  barracks  not  occupied  by 
troops. 

3d.  The  vigorous  measures  recommended  in  the  order 
of  April  13,  1855,  and  reiterated  in  the  order  of  Febru- 
ary 11,  1856,  relative  to  the  ventilation  and  fumigation 
of  wards,  are  to  be  put  into  effect. 

4th.  In  addition  to  the  chlorine  fumigations,  which 
should  be  made  morning  and  evening,  as  prescribed  in 
the  formulary  of  medical  hospitals,  it  is  recommended  to 
make  three  others  daily,  with  aromatic  plants,  such  as 
dried  sage,  after  the  manner  of  the  Turks.  These  aro- 
matic fumigations  should  be  made  morning  and  evening, 
a  little  while  after  the  chlorine  fumigations,  and  also  at 
noon. 

5th.  Typhoid  fever,  typhus,  and  dysentery,  being  fur- 
naces of  infectious  emanation,  it  is  necessary  to  fumigate 
with  chlorine  all  the  clothing  and  bedding  of  persons 
dying  from  these  diseases,  and  also  to  subject  to  fumi- 


THE   CRIMEAN   WAR.  173 

gation  (if  the  sick  can  change  their  beds)  all  the  bed 
clothing  used  during  the  course  of  the  disease. 

6th.  When  the  weather  is  so  mild  that  the  patients 
can  go  out,  it  is  ordered  to  fumigate  the  empty  bar- 
rack throughout  with  extra  quantities  of  chlorine,  taking 
care  to  hang  out  the  mattresses  and  blankets ;  to  keep 
the  ward  empty  as  long  as  possible,  that  it  may  be  puri- 
fied and  cleansed :  and  to  do  this  in  rotation  through 
every  ward  of  the  hospitals. 

7th.  The  doors  and  windows  are  to  be  opened  when 
the  weather  will  permit. 

8th.  Redoubled  care  should  be  taken  with  regard  to 
cleanliness — 1st,  of  the  sick,  by  washing  their  feet  when 
they  are  brought  in,  rubbing  with  warm  water  and  soap 
their  thighs,  legs,  and  arms,  when  it  is  not  possible  to 
give  them  a  bath,  or  when  the  bath  should  not  be  used ; 
but  to  do  nothing  without  the  previous  advice  of  a  phy- 
sician; and  2d,  in  the  wards,  corridors,  and  privies. 
Disinfectants  are  to  be  placed  permanently  in  places  for 
evacuations,  and  a  pinch  of  sulphate  of  iron  is  always 
to  be  left  in  the  night  vessels,  after  being  thoroughly 
cleansed. 

9th.  A  wash-house  should  be  built  at  Gulhane,  and 
another  at  Pera ;  the  former  to  be  devoted  to  washing 
the  linen  of  the  hospital  at  Gulhane  and  at  the  Univer- 
sity, the  other  that  of  the  hospital  at  Pera  and  the  Parade 
ground. 

10th.  Smoking  or  spitting  in  the  wards  to  be  prohi- 
bited. There  shall  be  assigned  a  place  for  smoking  in 
each  hospital,  and  wooden  spit-boxes  shall  be  placed  at 
regular  distances.  The  attendants  of  the  infirmaries 
must  not  spill  any  drinks,  broth,  or  other  liquids.  . 

11  th.  On  account  of  the  increase  in  the  number  of  the 
sick,  and  the  diminution  in  the  numbers  of  employees 
•in  consequence  of  death  or  sickness,  and  in  view  of  the 
good  results  already  attained  from  the  employment  of 
infirmary-dressers,  there  shall  be  designated  to  each  hos- 
pital a  certain  number  of  intelligent  assistant  attendants, 
to  keep  the  visiting  pass-books  and  perform  the  minor 
dressings. 

12th.  A  commission,  consisting  of  General  Pariset,.  of 


174  THE   CRIMEAN   WAR. 

the  sub-intendant  charged  with  the  hospital  service,  and 
Lieutenant-Colonel  Cadart,  commander  of  engineers, 
shall  visit  in  succession  all  the  hospitals  at  Constantino- 
ple, and  propose  such  improvements  as  circumstances 
may  require,  and  which  are  not  above  indicated. 

During  the  month  of  February,  the  number  of  sick  in 
the  Crimea  amounted  to  19,648,  of  whom  2,400  died, 
1,993  recovered,  and  8,738  were  sent  to  Constantinople ; 
and  during  the  same  month,  in  the  hospitals  of  Constan- 
tinople, the  sick  amounted  to  20,088,  of  whom  2,527 
died,  3,617  recovered,  649  were  sent  to  Gallipolis  and 
Nagara,  and  3,717  to  France. 

The  plague  in  Egypt,  in  1792,  is  spoken  of  with  terror. 
Said  the  illustrious  Desgenettes,  in  his  Medical  History 
of  the  Army  of  the  JEast,  "  from  the  most  accurate  and 
careful  reports,  the  army  in  Syria  lost  by  this  epidemic 
about  seven  hundred  men."  Our  typhus  committed 
much  more  dreadful  ravages. 

Notwithstanding  my  urgent  representations,  a  suffi- 
cient number  of  places  for  the  increasing  numbers  of 
typhic  patients  were  not  provided ;  and  on  the  28th  of 
February  I  addressed  the  following  letter  to  the  Minister 
of  War:— 

"  To  HIS  EXCELLENCY  THE  MARSHAL. — The  progress 
of  typhus  continues  upon  the  increase,  and  150  new 
cases  have  occurred  in  the  hospitals  at  Constantinople 
within  twenty-four  hours.  At  Maslak  No.  1,  among  420 
sick,  180  have  the  typhus,  and  at  Ramis-Tchifflick,  among 
700  sick,  there  are  250  cases  of  this  disease. 

"Your  Excellency  will  observe  that  there  exists  in 
certain  hospitals  a  serious  tendency  to  the  disease,  and 
that  it  demands  a  prompt  remedy.  The  remedy  is  sim- 
ple ; — air,  pure  air,  constantly  renewed ;  and  to  secure 
this,  we  should,  as  quickly  as  possible,  remove  one  half 
of  our  hospital  population  to  the  unoccupied  barracks  of. 
Maslak,  and  there  construct  a  great  encampment  and 
bivouac.  This  has  been  my  request,  morning  and  even- 
ing, daily. 

uOn  the  1st  of  March  they  promise  me  2,000  places 
in  barracks ;  but  these  will  be  inadequate ;  the  more  so, 
on  account  of  the  great  number  arriving  from  the  Crimea. 


THE   CRIMEAN   WAR.  175 

Yesterday,  650  sick  arrived  from  Eupatoria.  I  have 
visited  them,  and  they  are  properly  placed  on  litters 
and  furnished  with  blankets.  The  passage  only  occu- 
pied thirty-six  hours;  four  died  at  sea,  and  only  ten 
men,  one  of  whom  was  of  the  medical  staff,  had  the 
typhus. 

"  An  error  has  spread  among  the  authorities,  which  I 
have  endeavored  to  counteract,  because  it  might  be 
attended  with  pernicious  consequences.  This  is,  the 
comparison  of  typhus  with  cholera,  and  the  belief  that 
the  disease  will  disappear  of  its  own  accord.  The  cho- 
lera, whose  cause  is  unknown,  sweeps  forward  with  a 
force  that  nothing  can  check,  arrives  at  its  maximum, 
and  then  declines  and  spontaneously  disappears.  Typhus, 
on  the  contrary,  which  we  know  is  brought  on  by  priva- 
tions, continues  until  the  cause  is  removed.  Its  element 
is  human  miasm,  rendered  contagious  and  virulent,  in 
proportion  to  the  number  of  typhic  patients  assembled 
in  one  spot. 

"  It  was  because  the  great  measures  of  prevention 
were  neglected,  or  could  not  be  employed,  that  typhus, 
during  the  wars  of  the  empire,  was  seen  to  take  such  an 
extension,  and  strike  terror  into  the  hearts  of  cities.  So 
it  was  during  the  siege  of  Mayence.  The  wise  foresight 
of  the  government,  and  the  great  solicitude  of  your 
Excellency,  has  happily  not  left  us  disarmed  in  face  of 
the  epidemic.  We  have  barracks  for  25,000  soldiers 
awaiting  inmates.  Let  us  hasten  to  use  them.  But 
opening  barracks  to  satisfy  new  wants,  on  the  gradual 
arrival  of  our  sick  from  the  Crimea,  will  not  meet  the 
end  required  ;  it  is  simply  waiting  till  the  approaching 
tide  swallows  us  up.  And  yet  I  should  say,  that  the 
brave  and  worthy  General  Larchey  has  the  best  disposi- 
tion to  aid  in  any  measures,  as  also  has  the  Intendant 
Angot,  and  I  have  only  to  approve  my  excellent  rela- 
tions with  them.  Why  don't  we  act  more  rapidly  ? 
There  are,  apparently,  difficulties  in  the  execution,  of 
which  I  am  not  cognisant.  Thus,  I  have  heard  the 
Intendant  object,  in  one  of  our  general  conferences, 
against  my  plan  of  substituting  field  hospitals  for  the 
large  general  hospitals,  that  the  Minister  would  not 


176  THE   CRIMEAN   WAR. 

allow  the  establishment  of  them  out  of  the  Crimea.  I 
admit  that  the  instructions  are  plain,  to  one  who  has  no 
responsibility;  so  I  dare  not  complain,  and  can  only 
deplore  the  situation  in  which  I  am  placed. 

"  I  have  already  informed  your  Excellency  that  Gene- 
ral Larchey  has  permitted  us  to  select,  from  among  the 
soldiers  about  to  be  sent  to  France  on  sick  leave, 
two  hundred  auxiliaries  for  the  hospital  service,  to 
whom  we  will  entrust  the  visiting  pass  books  and  the 
charge  of  the  minor  dressings.  This  measure  assures 
the  perfect  fulfilment  of  the  service  ;  and  as  soon  as  the 
auxiliaries  recover  their  health,  we  will  send  them  back 
to  the  Crimea,  and  supply  their  places  with  others.  The 
following  are  the  last  daily  reports  of  the  progress  of  the 
typhus  in  our  hospitals  at  Constantinople : — 

New  Cases 
Remaining.    Recovered.        Died,     within  24  hours. 

February  25,  1,706  15  40  166 

"        26,  1,826  7  46  188 

"        27,  1,846  50  56  137 

"  Three  military  physicians  fell  victims  to  the  typhus 
on  the  26th ;  and  it  pains  me  to  inform  you  that  one  of 
them,  M.  Sagne,  Aide-Major  Physician,  in  a  moment  of 
delirium,  inflicted  upon  himself  several  cuts  with  a  razor, 
which  opened  the  arteries  of  both  arms,  and  he  died  of 
the  hemorrhage  that  followed. 

"M.  Gerard,  Major-Physician,  died  at  the  hospital, 
at  the  Russian  embassy;  and  the  principal  physician, 
Volage,  has  been  poisoned  by  the  breath  of  the 
sick,  upon  whom  he  lavished  the  treasures  of  his 
science  and  self-denial.  His  death  has  caused  the  keen- 
est regrets. 

"  Within  three  days  six  new  cases  of  typhus  have  ap- 
peared in  the  medical  corps  at  Constantinople,  and  yet 
no  one  hesitates,  and  each  will  discharge  his  duty  till 
the  end. 

"  P.S.  General  Larchey,  to  whom  I  have  communi- 
cated tfcis  report,  has  brought  to  my  knowledge  a  minis- 
terial dispatch,  this  moment  received,  in  which  your 
Excellency  has  ordered  the  ailing  soldiers  of  the  Crimean 
regiments  to  be  sent  to  Constantinople.  This  measure 


THE    CRIMEAN   WAR.  177 

would  have  been  well  when  I  advised  it ;  but  the  ailing 
are  to-day  the  sick.  We  are  going  to  open  wide  to  them, 
the  doors  of  the  camps  of  Maslak,  which  soon,  I  trust, 
will  be  converted  into  hospital  establishments." 

The  courier,  on  the  morrow,  bore  another  dispatch, 
which  I  addressed  to  his  Excellency  the  Marshal  Pe- 
lissier. 

"  CONSTANTINOPLE,  February  29,  1856.    - 

"To  HIS  EXCELLENCY  THE  MARSHAL. — I  have  the 
honor  to  address  to  your  Excellency  a  report  upon  the 
progress  of  the  typhus  in  our  hospitals  at  Constantinople, 
which  will  enable  you,  with  the  documents  transmitted 
directly  from  the  Crimea,  to  understand  the  sanitary 
condition  of  the  army.  I  cause  a  report  to  be  made  to 
me  daily  of  the  number  of  men  tainted  with  the  typhus, 
of  the  new  cases  appearing  during  the  last  twenty-four 
hours,  the  number  of  recoveries,  and  the  mortality. 

"These  reports  are  instructive,  and  the  following 
table  gives  their  returns  since  the  20th  of  the  present 
month : — 

New  Cases 

Number  of  Ty-     within  24 
February      phus  patients.          k«ur».j         Eocovered.          Died. 

20  1,450  62  4  36 

21  1,517  111  10  44 

22  1,586  168  9  62 

23  1,556  105  27  41 

24  1,615  128  8  43 

25  1,706  166  15  40 

26  1,826  188  7  46 

27  1/848  137  50  56 

28  1,927  168  39  50 

29  1,969  178  79  60 

*'  The  epidemic  wave  is  rising,  and  we  can  only  escape 
it  by  watching  its  conditions,  and  raising  against  it  an 
effectual  barrier.  It  is  only  necessary  for  you  to  cast 
your  eyes  over  the  tables  showing  the  new  eases  occur- 
ring within  twenty-four  hours  to  convince  yourself  of 
the  contagion  of  typhus,  and  of  the  necessity  of  adopt- 
ing measures  for  limiting  its  spread  as  quickly  as  possi- 
ble. It  would  be  well  to  advise  means  to  retain  all  the 
men  tainted  with  typhus  in  the  Crimea,  if  it  could  be 
done  without  exposing  the  army  to  too  great  risks.  But 

9 


178  THE   CRIMEAN  WAE. 

in  the  mean  time,  it  is  easy  to  arrest  the  typhus  at  Con- 
stantinople, and  to  prevent  it  from  spreading.  We  have 
providentially  in  our  camps  empty  barracks  for  25,000 
men.  They,  are  arranged  upon  elevated  grounds,  and 
are  in  good  hygienic  condition.  Let  ns  remove  thither 
half  of  our  hospital  population,  some  5,000  sick,  and  I 
will  answer  for  it  that  we  will  check  the  progress  of  the 
mortality  from  typhus  almost  immediately  ; — for  what, 
sir,  is  necessary  to  cure  this  disease  ?  Only  an  abundance 
of  pure  air,  constantly  renewed,  in  place  of  air  charged 
with  contagious  miasms.  Every  form  of  medical  treat- 
ment, whatever  may  be  its  virtues,  will  prove  a  striking 
failure,  if  the  first  essential  condition,  that  of  disencum- 
berment,  is  not  fulfilled.  For  this  end,  I  ask  only  some 
field  hospitals  and  beds.  Straw  beds,  even,  would  suffice 
for  probable  wants,  and  the  necessity  for  them  would, 
I  trust,  disappear  with  the  return  of  fine  weather.  This 
measure  ought  not  to  present  great  difficulties  in  exe- 
cution. We  shall  have,  in  a  short  time,  5,000  places 
under  barracks  to  satisfy  the  new  wants  as  they  shall 
arise  ;  but  in  so  doing,  we  allow  ourselves  to  be  pressed 
upon  by  necessity,  we  do  not  meet  it.  We  shall  find 
ourselves  some  day  invaded  by  the  sick,  in  place  of  hav- 
ing prevented  the  sickness. 

"Pardon  me,  Marshal,  for  expressing  myself  to  the 
point.  I  must  tell  your  Excellency  the  truth.  Myself  a 
man  of  action,  field  hospital  surgeon,  I  would  wish  to 
move  off  with  some  supplies,  and  with  my  sick  to  esta- 
blish a  great  bivouac  in  the  unoccupied  camps.  The 
administration,  on  which  all  responsibility  rests,  cannot, 
I  am  aware,  act  so  quickly.  They  encounter,  besides, 
great  difficulties  in  recruiting  auxiliary  infirmary  at- 
tendants. 

"  As  for  the  personnel  of  the  health  service,  although 
reduced  by  mortality  and  sickness,  it  can  yet  face  pro- 
bable events,  if  the  commander,  whose  solicitude  has 
never  been  dormant,  still  continues  to  second  our  efforts. 
We  have  here  upon  our  hands  10,000  sick  soldiers, 
who,  in  place  of  being  sent  to  France  on  sick  leave, 
would  like  nothing  better  than  to  become  our  infirmary 
attendants.  They  would  otherwise  be  lost,  so  far  as 


THE    CRIMEAN    WAE.  179 

being  of  any  service  in  the  Crimea,  during  the  next 
four  months.  By  placing  them  in  charge  of  the  visit- 
ing passbooks  and  minor  dressings,  we  may  hold 
them  in  reserve,  and  as  soon  as  they  become  fit  to 
resume  active  service,  we  might  send  them  away  and 
replace  them  by  others. 

"  I  visited  the  sick  on  -board  the  ships  arriving  from 
the  Crimea,  and  presided  over  the  arrangements  for 
placing  them  upon  steamers  to  be  sent  to  France.  I  can 
affirm  that  every  measure  possible,  suggested  by  human- 
ity and  affection,  has  been  adopted.  I  have  taken  espe- 
cial pains  not  to  allow  any  sick  to  embark  that  were 
tainted  with  typhus;  but  it  is  not  within  the  power 
of  man  to  prevent  the  malady  from  breaking  out  upon 
the  voyage.  We  have  had  for  a  year  2,500  places  pre- 
pared for  the  sick  in  the  lazaretto  of  Marseilles,  500  in 
that  of  Port-Vendres,  and  1,500  in  that  of  Toulon. 
Thus,  in  this  way,  everything  has  been  foreseen  by  his 
Excellency  the  Minister  of  War. 

"  My  relations  with  M.  Scrive  have  brought  to  my 
knowledge  the  excellent  arrangements  adopted  in  the 
Crimea.  It  is  of  the  highest  importance  that  the  site  of 
the  camps  should  be  changed  as  soon  as  the  weather  will 
permit ;  but,  in  the  mean  time,  it  is  necessary  to  empty 
and  cleanse  the  field  hospitals. 

"  Thus  far  the  epidemic  has  happily  been  limited  to 
the  hospitals,  without  entering  the  camps.  On  the  26th, 
three  physicians  died  of  typhus,  others  are  now  in  great 
danger,  and  twenty-four  are  under  treatment.  Everyone 
does  his  duty  with  self-denial  and  with  redoubled  efforts. 
We  have  already  lost  eight  military  physicians  killed, 
and  thirty  wounded  on  this  battle-field.  I  class  among 
the  wounded  the  physicians  who  have  contracted  the 
typhus  among  the  sick  whom  they  have  attended. 
When  the  proper  moment  shall  have  arrived,  I  will 
with  confidence  appeal  to  your  high  benevolence  con- 
cerning this  class  of  officials,  who  since  the  beginning  of 
the  campaign  have  enjoyed  the  honorable  privilege  of 
conciliating  more  and  more  the  earnest  sympathies  of 
the  army." 

Unfortunately,  the  weather  became  unfavorable.     On 


180  THE  CRIMEA;*  WAR. 

the  3d  of  March,  1856,  the  Intendant-general  addressed 
me  as  follows  from  the  general  head-quarters  : — 

"I  have  read  very  carefully  your  report  upon  the 
sanitary  condition  at  Constantinople.  We  are  passing 
through  a  terrible  crisis,  and  most  of  all  need  pleasant 
weather  to  enable  us  to  pass  through  it  in  the  Crimea ; 
for  a  short  continuance  of  fine  weather  would  enable  us 
to  complete  the  purification  of  our  ambulance  hospitals. 
Already  the  old  field  hospitals  of  the  1st  corps  have  been 
rearranged  throughout,  and  are  now  perfectly  healthy. 
We  need  to  do  the  same  thing  everywhere ;  but  the 
weather  still  continues  so  bad  that  we  meet  with  the 
greatest  obstacles.  Meanwhile,  we  observe  a  marked 
improvement  in  the  general  health,  and  the  number  of 
daily  entries  has  sensibly  diminished  during  the  last  ten 
or  twelve  days.  This  may  be  due,  in  a  great  degree,  to 
the  oil,  vinegar,  potatoes,  and  mixed  vegetables  which  I 
have  caused  to  be  distributed  among  the  troops,  so  that 
there  are  but  very  few  scorbutic  patients  now  in  the 

field  hospitals I  think 'that  the  Marshal  will  give 

orders  for  the  employment,  to  the  greatest  extent  possi- 
ble, of  the  barrack  camp  at  Maslak  for  the  use  that  you 
suggest.  I  am  entirely  of  your  opinion,  that  when 
possible,  a  seat  of  infectious  disease  should  be  aban- 
doned without  delay.  I  weh1  remember  that  during 
the  cholera,  at  Varna  I  had  to  fight  it  in  like  man- 
ner ;  I  required  that  the  choleraic  patients  should 
be  taken  out  of  the  hospitals,  and  placed  in  tents ;  I 
demanded  pure  air,  and  was  answered  that  heat  was 
needed.  The  number  of  sick  increased,  and  they  were  at 
length  forced  to  have  recourse  to  the  tents,  and  then 
learned  that  this  was  not  so  bad  a  plan  after  all.  It 
appears  to  me  that  it  is  the  same  thing  with  typhus, 
except  that  large  well-ventilated  barracks,  and  only  a 
few  sick  placed  in  them,  would  prove  better  than 
tents." 

On  the  same  day,  a  telegraphic  dispatch  from  Marshal 
Pelissier,  sent  to  Constantinople  the  orders  necessary  for 
the  immediate  establishment  of  field  hospitals  for  5,000 
sick,  and  on  that  day  I  wrote  as  follows  to  the  Minister 
of  War:— 


THE   CRIMEAN   WAR.  181 

"The  contagion  continues  its  ravages.  It  will  con- 
tinue thus,  so  long  as  we  cannot  carry  into  the  barracks 
of  the  unoccupied  camps  a  third  or  a  half  of  the  sick  in 
the  hospitals.  Of  the  5,000  places  that  I  have  requested, 
1,000  have  been  furnished,  and  we  have  thus  been  able 
to  create  a  little  space  in  our  hospitals.  This  at  once 
produced  a  diminution  in  the  number  of  new  cases.  In 
fact,  on  the  1st  of. March,  this  number  had  fallen  to  93  ; 
but,  unhappily,  this  respite  was  enjoyed  but  for  a  mo- 
ment, and  new  additions  of  sick,  sent  from  the  army 
before  Sebastopol,  have  encumbered  our  hospitals,  and 
have  obliged  us  to  encroach  upon  the  rooms  reserved 
for  the  sick  who  are  dangerously  ill.  The  number 
of  new  cases  has  thus  been  increased  beyond  any 
former  period,  amounting  to  257  within  twenty-four 
hours. 

"  By  constant  airing  and  ventilation  of  the  wards ;  by 
five  fumigations  daily,  two  with  chlorine,  and  three  with 
aromatic  herbs ;  by  placing  under  the  bed  of  each  typhic 
patient  a  cup  of  chloride  of  lime;  by  scouring  the  floors 
and  whitewashing  the  walls  of  the  wards,  one  after  ano- 
ther ;  by  keeping  always  in  the  chamber  vessels  some 
sulphate  of  iron ;  by  making  large  openings  in  the  privies, 
for  their  thorough  ventilation ;  by  having,  if  possible, 
two  beds  for  each  man  gravely  affected  by  the  typhus, 
and  fumigating  each  bed  for  twenty-four  hours  after  it 
is  left ;  by  washing  the  linen  in  boiling  water ;  by  an 
improvement  in  the  regulations  for  the  diet,  and  a  more 
substantial  broth,  and  Bordeaux  wine  for  the  sick — all 
of  which  measures  we  have  regularly  enforced — are  we 
able  to  resist  the  pestilence,  which  nevertheless  is  gain- 
ing ground  upon  us  daily.  We  shall  be  able  to  conquer 
it  only  when  we  shall  have  taken  possession  of  the  new 
hospital  establishments  prepared  in  the  camps  at  Maslak. 
It  is  not  without  trouble  that  I  can  destroy  in  the  mind 
of  the  command  and  the  administration  their  feeling  of 
security  in  the  midst  of  so  much  danger : — they  believe 
that  the  typhus  brought  from  Sebastopol  will  disappear 
at  Constantinople,  when  it  ceases  to  be  imported  from 
the  Crimea.  It  would  result  from  this,  that  we  need 
not  trouble  ourselves  here  on  account  of  the  epidemic. 


182  THE   CRIMEAN   WAR. 

In  the  meantime,  the  epidemic  spreads  rapidly  among 
our  hospitals  at  Constantinople.  The  only  way  to  stop 
it  is  to  remove  half  of  the  sick  to  empty  barracks.  Let 
this  be  done,  and  I  will  answer  for  it  that  the  march 
and  fatality  of  the  typhus  will  be  almost  immediately 
checked.  I  ask  only  for  field  hospitals.  The  measure 
appears  to  present  great  difficulties  in  the  execution. 
More  places  in  barracks  are  promised,  in  proportion  as 
new  wants  arise.  By  so  doing,  we  wait  till  necessity 
compels  us  to  act — we  shah1  find  ourselves  some  day 
invaded  and  powerless.  I  would  wish  to  go  with  some 
supplies,  and  with  my  sick  establish  a  great  bivouac  in 
the  unoccupied  camps." 

At  the  close  of  a  new  report,  written  on  the  6th  of 
March,  the  minister  addressed  to  General  Larchey,  at 
Constantinople,  a  telegraphic  dispatch,  in  the  following 
word's : — 

"  The  last  report  of  M.  Baudens  makes  me  fear  that 
the  order  for  placing  the  sick  in  barracks,  or  under  well- 
aired  tents,  has  not  been  sufficiently  carried  out.  Do 
everything  that  M.  Baudens  desires." 

Night  and  day  the  health  officers  remained  among 
their  typhic  patients,  and  scarcely  left  them,  except  to 
follow  in  the  funeral  procession  and  attend  the  burial 
of  one  of  their  number.  Forty-six  have  perished,  struck 
by  typhus,*  while  bravely  contesting  its  ravages,  and 
eighty-two  have  died  during  the  campaign.  Never  has 
the  medical  staff  found  a  finer  occasion  for  proving  their 
traditional  devotion  to  France,  and  to  the  army  which 
has  always  regarded  them  with  affection,  and  in  the 


*  The  names  of  the  physicians  and  surgeons  dying  of  the  typhus 
were  as  follows :  — Principal  Physicians,  Volage  and  Barby.  Majors, 
Felix,  Goutt,  Bonnet-Masimbert,  Frette-Damicourt,  Moulinier,  Braun- 
wald,  Girard,  Rampont,  Leclere,  Pegat,  Fuel,  Berthemot,  and  Fey- 
russet.  Aides-Majors,  Le  Clere,  Cordeau,  Dulac,  Savaete,  Gillin,  Mil- 
tenberger,  Perrin,  Molinard,  Gueury,  Lasserie,  Lemarque,  Perry, 
Desblancs,  and  Masson.  Aides-Major  Physicians,  Leker,  Bouquerot, 
Servy,  Demanet,  Dartigaux,  Ragu,  Lardy,  Forget,  Sagne,  and  Fournier. 
Sub-aide  Physicians,  Jacob,  Godquin,  Sautier,  and  Labretaigne.  Aide- 
Major  Apothecaries,  Boussard,  Carron,  and  Granat. 


THE   CRIMEAN   WAB.  183 

ranks  of  which  they  have  always  been  so  eager  to  be 
classed.* 

On  the  2d  of  March,  the  population  of  Pera  was 
saddened  by  the  spectacle  of  three  hearses,  bearing  in 
the  same  train  the  bodies  of  three  physicians,  who  had 
fallen  together,  the  victims  of  their  own  selfdenial. 
These  gloomy  processions  to  the  field  of  the  dead  break 
the  spirit ;  for  each  one  may  truly  ask  himself:  "Who 
of  us  to-morrow  will  receive  this  last  sad  adieu  ?"  It 
fell  to  the  share  of  the  Medical  Inspector  to  perform  the 
painful  duty  of  pronouncing  the  last  words  over  the 
tomb  of  his  unfortunate  comrades. 

The  pious  sisterhood  of  Saint-Vin cent-de-Paul  paid 
also  a  large  tribute  to  disease,  and  thirty-one  perished 
near  their  grateful  sick,  upon  whose  attendance  they 
were  unwearied;  never  showing  signs  of  fatigue,  nor 
disgust,  nor  anxiety  about  themselves  in  their  delicate 
and  assiduous  attentions.  Of  those  who  died,  twenty- 
four  were  struck  by  the  typhus.  The  first  one  of  them 
who  took  the  disease  was  Sister  Walbin,  whose  last 
words  were:  "  The  only  favor  I  ask,  is  to  be  buried  with 
the  soldiers — they  will  be  lonesome  without  me." 

Meanwhile,  instead  of  opening  field  hospitals,  and 
ample  quarters  in  barracks,  they  continued  to  send  the 
sick  to  France.  Within  a  month,  6,000  were  sent  thither 
in  transports,  and  half  the  vessels,  instead  of  returning 
to  the  Crimea,  were  despatched  to  Marseilles  and  Tou- 
lon. For  the  want  of  ships,  the  Crimea  could  not  send 
us  so  many  sick ;  and  so  the  system  continued  as  it  was 
— the  Crimea  relieving  itself  upon  us,  and  we  upon 
France.  Two  hundred  soldiers  a  day  died  between  the 
Crimea  and  Constantinople ;  and  the  sailors,  falling  vic- 
tims to  the  contagion,  entered  the  hospitals  along  with 
the  sick  whom  they  brought.  From  Constantinople, 
the  disease  which  infected  the  vessels  was  carried  to 
Marseilles  ;  and  it  would  seern  that  we  were  indefinitely 
threatened  with  this  real  and  terrible  disaster.  It  was 

*  France  knows  how  to  appreciate  every  kind  of  heroism,  and  yet 
the  widows  of  medical  officers  are  deprived,  by  a  decree  that  doubles 
the  pensions  of  retreat  for  the  officers  of  the  army,  of  the  advantages 
conceded  to  the  widows  of  the  latter. — AUTHOR'S  NOTE. 


184  TIIE   CRIMEAN  WAE. 

a  time  for  prompt  action,  under  penalty  of  soon  being 
rendered  powerless — it  implied  the  very  existence  of  the 
army. 

Two  great  measures  were  to  be  taken  ;  the  first  was 
to  send  no  more  sick  from  Constantinople  to  France ; 
and  the  second,  to  keep  all  the  typhic  patients  in  the 
Crimea,  to  the  exclusion  of  the  other  sick,  who  might 
be  sent  to  Constantinople. 

I  left  for  Sebastopol  on  the  9th  of  March,  1856,  and 
at  the  moment  of  embarkation  received  a  visit  from 
M.  Girette,  the  Director  of  the  Imperial  Mail  Boat 
Company.  He  said :  "  The  typhus  is  making  such 
ravages  in  the  ships  of  the  company,  infected  by 
the  constant  transmission  of  the  sick,  that  the  mail 
service  will  be  forced,  in  a  few  days,  to  be  discon- 
tinued on  the  route  from  Sebastopol  to  Marseilles.'* 
Many  of  the  sailors,  firemen,  and  commanding  offi- 
cers of  these  vessels  have  died  of  the  disease,  and  others 
are  sick.  M.  Girette  had  not  been  able  to  replace 
these  by  others. 

Immediately  upon  arriving  in  the  Crimea,  I  visited  a 
part  of  the  camps  and  field  hospitals ;  and  on  the  15th 
of  March,  without  further  delay,  informed  Marshal 
Pelissier  upon  the  sanitary  state  of  the  army.  The  first 
question  that  I  proposed  to  investigate  was — whether 
the  typhus  raged  only  in  the  field  hospitals,  or  wrhether 
it  had  also  spread  in  the  regiments.  I  became  satisfied 
that  the  latter  was  but  too  truly  the  case,  and  gave  direc- 
tions that  they  should  watch  with  the  most  scrupulous- 
care,  so  as  not  to  leave,  either  in  the  regimental  infirm- 
aries or  the  tents,  any  men  tainted  with  the  typhus ; — 
on  the  first  premonitory  symptoms,  they  should  be 
placed  in  the  field  hospitals.  The  human  miasm  of  this 
disease  does  not  become  contagious  until  after  the 
disease  has  continued  several  days,  and  especially  during 
the  period  of  the  critical  sweats  ;*  and  for  this  reason, 
the  recommendation  here  given  becomes  of  the  highest 
importance.  I  also  demanded  that  they  should  change 

*  Tke  correctness  of  this  point  of  theory  is  confirmed  by  the  views 
of  Hildebrand,  and  was  in  conformity  with  the  facts  observed  in  all 
the  regiments  hi  the  Crimea. 


THE    CRIMEAN    WAR.  185 

the  sites  of  all  the  camps  from  a  soil  that  had  become 
deeply  impregnated  with  impurities  ;  and  that  as  often 
as  the  weather  permitted,  they  should  take  down  their 
tents,  or  at  least  raise  the  curtain  that  extended  around 
the  bottom  to  the  height  of  a  few  inches  from  the 
ground.  They  might  thus  prevent  the  soldiers  from 
remaining  a  great  part  of  the  day  in  their  tents,  which 
they  kept  hermetically  closed,  even  in  the  finest  weather. 
The  floor  of  the  tents,  once  dry,  ought  to  receive  a 
coat  of  wThite-wash,  renewed  from  time  to  time,  which 
would  cleanse  and  harden  the  surface.  The  bed-clothing 
and  garments  of  the  sick  should  be  hung  up  in  the  sun, 
as  long  a  time  each  day  as  possible.  Those  which  had 
been  used  by  patients  infected  with  the  typhus  ought  to 
be  exposed  for  several  hours  to  chlorine  fumigation  be- 
fore being  again  used. 

A  considerable  number  of  regimental  infirmaries  had 
a  defective  arrangement,  and,  in  place  of  two  barracks, 
several  had  but  one.  The  ground  was  not  always  pro- 
tected against  humidity,  and  camp  bedsteads,  or  at  least 
boards,  were  not  always  furnished  to  keep  the  sick  from 
the  ground.  The  interior  of  the  barracks  should  be 
whitewashed  with  quicklime,  and  the  floor  and  walls 
exposed  to  fumigations  at  frequent  intervals.  The 
rations  should  be  increased  a  sixth  part  in  the  article  of 
preserved  meats,  and  a  supplementary  ration  of  wine 
should  be  issued  daily,  to  give  the  army  a  greater  power 
of  resistance  against  the  attacks  of  the  malady. 

I  also  recommended,  as  an  excellent  auxiliary  to  good 
hygienic  condition,  that  exercise  should  be  taken,  to  a 
judicious  extent,  when  the  weather  was  fine ;  for  nothing 
is  so  pernicious  as  perfect  repose,  and  idleness  enervates 
both  body  and  mind.  The  six  thousand  mattresses  dis- 
tributed four  months  previously,  tinder  the  direction  of 
the  Intendant-general,  were,  in  part,  out  of  condition  for 
service.  There  remained  of  them  about  2,500,  more  or 
less.  There  was  scarcely  barrack  room  for  more  than 
4,500  sick.  The  blankets  were  sufficiently  numerous, 
but  almost  all  of  them  were  tainted ;  sheets  and  hospital 
clothes  were  wanting,  as  were  also  proper  means  for 
washing. 

9* 


186  THE    CRIMEAN   WAR. 

To  supply  these  resources,  which  are  so  quickly  ex- 
pended in  a  campaign,  AVC  were  obliged  to  overcome 
very  great  difficulties,  in  a  country  stripped  of  every- 
thing. The  last  ten  days  of  February,  the  20th  to  29th, 
showed  519  sick  discharged  from  the  field  hospitals 
cured,  and  873  had  died.  In  continuing  the  compara- 
tive inquiry,  so  as  to  include  only  those  tainted  with 
typhus,  we  shall  observe  a  still  more  terrible  result ;  for 
we  have  had  in  this  disease  only  27  recoveries  to  385 
deaths,  while  typhus,  under  ordinary  conditions,  does 
not  carry  off  more  than  a  sixth  part  of  the  number  sick. 
Thus,  at  Constantinople,  of  422  hospital  attendants 
attacked  with  this  disease  in  our  hospitals,  only  42  died. 

In  consequence  of  these  facts,  I  proposed  that  we 
should  retain  in  the  Crimea  only  those  sick  with  typhus, 
and  that  we  should  send  all  the  others  to  Constantino- 
ple ;  and  as  the  latter  were  the  most  numerous,  their 
departure  would  produce  an  immediate  disencum- 
brance,  and  allow  us  to  use  all  our  resources  for  the  bene- 
fit of  our  unfortunate  typhic  patients.  The  latter,  being 
retained  in  the  Crimea,  could  no  longer  spread  contagion 
in  the  ships  and  among  the  hospitals  at  Constantinople.* 

Two  hours  after  my  sending  in  this  report,  Marshal 
Pelissier  replied :  "  I  have  ordered  that  all  your  direc- 
tions shall  be  carried  immediately  into  effect  in  the  regi- 
ments and  field  hospitals." 

At  the  same  time,  strong  encouragement  came  to  me 
from  France.  On  the  15th  of  March,  the  Minister  of 
War  wrote :  "  I  await  with  much  anxiety  the  news  of 
your  sanitary  condition.  Tell  your  associates  in  the 
liealth  service,  that  I  thank  them.  This  word  expresses 
the  whole.  The  Emperor  is  informed  of  the  new  proofs 
they  have  shown  of  their  zeal,  their  courage,  and  their 
self-denial.  He  has  always  relied  upon  these  officers; 
but  his  faith  in  their  devotion  has  been  increased  by  a 
knowledge  of  the  energy  they  have  shown  upon  this 
occasion.  I  send  to  your  assistance  some  sisters  of  cha- 
rity, 200  infirmary  attendants,  and  20  aides.  Can  such 
a  supply  relieve  you  ?  At  Marseilles  and  Toulon,  there 

*  See  in  the  Appendix  the  original  report. 


THE    CRIMEAN    WAR.  187 

is  much  excitement,  but  nothing  serious  has  occurred, 
although  there  is  great  apprehension.  We  are  turning 
to  account  the  good  and  prudent  arrangements  taken 
by  you  in  your  tour  in  Provence.  The  Emperor  wrote 
to  me  this  morning,  and  speaking  of  the  sanitary  condi- 
tion of  the  army,  he  added  :  *  It  is  necessary  to  establish 
as  soon  as  possible  the  field  hospitals  in  barracks,  which 
M.  Baudens  has  advised,  and  let  pressing  orders  be 
given  accordingly.'  I  cannot  do  better  than  report  the 
very  words  of  the  Emperor.  I  have  addressed  General 
Larchey  by  telegraph  and  letter,  and  have  ordered  that 
as  many  as  possible  of  the  sick  shall  be  placed  at  Maslak. 
I  have  told  him  to  arrange  with  the  physicians,  outside 
of  all  the  pre-existing  regulations,  relative  to  the  diet  of 
the  sick.  He  has  full  powers,  and  I  will  approve  every- 
thing he  may  do.  The  Russian  prisoners  on  the  island 
of  Prinkipo  are  in  perfect  health.  I  think  that  after 
their  departure  from  Russia,  if  that  event  has  not 
already  occurred,  a  fine  field-hospital  might  be  esta- 
blished there.  I  have  given  orders  to  allow  an  addi- 
tional pay  to  the  physicians  of  one  hundred  francs  per 
month.*  I  conclude  by  renewing  the  recommendation 
to  retain  at  Constantinople  all  the  sick  whose  removal  is 
not  demanded  by  want  of  space  or  by  the  absence  of 
sanitary  necessities."  The  Director  of  the  War  Depart- 
ment, M.  Darrican,  wrote  to  me:  "Your  position  is 
terrible.  We  will  do  everything  possible  to  relieve  it." 
On  the  same  day,  the  President  of  the  Council  of 
Health  in  the  Army  addressed  to  me  the  following 
letter :— f 

"  MY    VERY    DEAR    AND    HONORED     COLLEAGUE — The 

Council  of  Health  has,  with  the  greatest  interest,  taken 
into  consideration  the  dispatches  which  you  have  suc- 

*  The  radical  decree  of  1852  having  abolished  the  extra  war 
allowances  to  the  medical  staff  of  the  army,  privations  that  endan- 
gered their  health  were  the  result.  The  Minister  of  War,  whose  atten- 
tion I  had  called  to  this  pernicious  condition  of  affairs,  readily  modified 
the  evil  growing  out  of  the  decree,  by  ordering  a  supplementary  allow- 
ance.— AUTHOR'S  NOTE. 

f  The  Council  of  Health  consists  of  three  or  five  Inspectors,  desig- 
nated annually  by  the  Minister  of  War. — TK. 


188  THE   CRIMEAN   WAR. 

cessively  addressed  to  it,  as  also  your  last  reports  to  the 
Minister  upon  the  general  aspect  of  the  medical  service 
at  Constantinople. 

"The  Council  hopes  that  the  hygienic  and  prophy- 
lactic measures  which  you  have  proposed,  and  whose 
execution  you  have  yourself  superintended,  will  be  fol- 
lowed by  the  favorable  results  that  you  anticipate,  and 
that  they  will  contribute,  together  with  the  reforms 
which  you  announce  in  the  hospital  rations,  to  the  pre- 
vention of  the  development  of  infectious  diseases,  and 
to  the  arrest  of  their  progress.  The  Council  follows 
you  in  your  labors  with  very  great  interest,  and  ear- 
nestly prays  that  the  insufficiency  in  the  number  of  the 
medical  officers  may  not  prevent  the  sick  from  receiving 
those  assiduous  attentions  that  may  be  so  necessary  for 
them. 

"The  Council,  deeply  touched  by  the  death  of  so- 
great  a  number  of  its  courageous  fellow  laborers,  returns 
you  its  thanks  for  having  expressed  over  their  graves  in 
its  behalf  the  just  regrets  which  their  loss  has  inspired, 
and  desires  you  to  be  the  medium  for  expressing  to  all 
the  health  officers  of  the  army  of  the  East  the  sentiments 
which  are  impressed  upon  it  by  their  zeal,  devotion,  and 
self-denial  in  the  midst  of  great  dangers." 

On  the  16th  of  March,  Marshal  Pelissier  decided  that 
two  field  hospitals,  which  had  become  thoroughly  in- 
fected, and  which  I  advised  to  be  abandoned,  should  be 
at  once  closed.  The  engineers  immediately  constructed 
two  others,  upon  sites  selected  by  me,  upon  high  pla- 
teaux, placing  the  barracks  twenty  yards  from  one 
another,  and  the  quarters  of  the  physicians  over  two 
hundred  yards  from  the  hospitals.  These  two  establish- 
ments have  remained  healthy,  and  have  proved  emi- 
nently useful.  On  the  same  day  Marshal  Pelissier 
ordered  all  the  sick  in  the  Crimea  to  be  sent  to  Constan- 
tinople, except  those  sick  with  the  typhus.  I  passed 
through  the  regiments,  one  after  another ;  I  conversed 
with  the  colonels,  and  imparted  to  them  my  observa- 
tions. My  counsels  w^ere  everywhere  listened  to  with 
eagerness,  although  not  always  followed  with  religious 
care.  I  could  show  that  the  mortality  and  sickness  of 


THE    CRIMEAN   WAE.  189 

the  several  regiments  always  bore  an  exact  relation  to 
the  degree  of  solicitude  which  the  colonels  bestowed 
upon  their  soldiers.* 

By  the  28th  of  March,  the  good  effects  of  these  mea- 
sures were  easily  observed,  notwithstanding  the  pro- 
tracted and  severe  winter.  I  informed  Marshal  Pelissier 
of  this,  drawing  his  attention  also  to  some  much  regret- 
ted neglects,  in  the  following  report : — 

"  The  measures  which  I  recommended  in  my  report 
of  the  15th  instant,  for  arresting  the  progress  of  typhus, 
and  which  your  Excellency  directed  to  be  immediately 
carried  into  effect  in  the  regiments  and  field  hospitals, 
have  borne  their  fruits. 

"During  the  last  ten  days,  the  number  of  those  enter- 
ing the  field  hospitals  shows  a  reduction  of  500,  as  com- 
pared with  those  of  the  te#  days  previous,  and  the 
diseases  are  much  less  severe.  The  mortality  in  the 
Crimea  has  been  reduced  one-tenth.  The  cases  of  scurvy, 
on  the  20th  of  March,  in  our  field  hospitals,  amounted 
to  only  649,  in  consequence  of  many  being  sent  away ; 
but  at  Constantinople  we  have  in  our  hospitals,  among 
10,000  sick,  4,000  scorbutic  cases.  This  disease,  how- 
ever, still  fills,  to  a  great  degree,  our  regimental  infirma- 
ries ;  but  is  sensibly  ameliorated  since  the  distribution 
of  fresh  vegetables  and  the  return  of  the  sun.  Some 
anti-scorbutic  lemon  juice,  prepared  according  to  the 
English  method,  has  been  placed  at  the  disposal  of  the 
physicians  in  the  army,  and  I  look  for  good  results 
from  it. 


*  A  general  in  the  army  of  the  Potomac,  noted  for  the  care  which 
he  bestows  upon  the  welfare  of  his  command,  made  a  somewhat  simi- 
lar remark  to  the  editor  of  this  volume,  upon  the  occasion  of  a  visit  for 
purposes  of  sanitary  inspection,  in  March,  1862.  He  stated  that  his 
observations  and  inquiries  had  convinced  him  that  the  sickness  of  a 
regiment  bore  an  inverse  ratio  to  the  efficiency  of  its  discipline ;  and 
produced  the  records  of  his  surgeons  to  prove,  that  for  months  the 
sickness  had  been  greatest  in  those  regiments  which  he  ranked  as  the 
worst  officered.  All  experience  tends  to  prove,  that  without  strict 
rules,  well  enforced,  soldiers  will  not  attend  to  those  details  of  neat- 
ness of  the  person,  the  quarters,  and  the  camp,  so  essential  to  health, 
In  no  way  does  the  energetic  disciplinarian  appear  to  greater  advan- 
tage than  in  this. — TR. 


190  THE    CEIMEAN   WAR. 

"So  much  for  the  general  conditions.  Let  us  now 
examine  the  state  of  the  typhus. 

"  This  disease  has  always  one  foot  in  the  camp  and 
the  other  in  the  field  hospital.  It  has  not  gained  ground ; 
but  still  it  must  be  acknowledged  that  it  retains  its  hold, 
and  menaces  the  army.  We  can  safely  assert  that  there 
are  now  a  greater  number  of  cures ;  medicine  is,  with- 
out doubt,  favorable  in  some  conditions,  and  its  impo- 
tency  less  marked.  Thus,  during  the  last  eleven  days, 
we  have  counted  283  recoveries,  to  699  deaths.  The 
sum  total  is  not  much  increased,  as  it  was  1,457  on  the 
16th  of  March,  and  1,606  on  the  26th.  It  should  be 
remarked,  that  since  the  17th  of  this  month,  we  have 
not  sent  to  Constantinople  a  single  person  tainted  with 
typhus. 

u  Two  hundred  and  eighty-three  cures  in  eleven  days 
is  evidently  a  very  good  comparative  result,  when  we 
remember,  that  since  the  1st  of  January,  each  period  of 
ten  days  showed  that  the  number  of  soldiers  cured  was 
7,  14,  25,  36,  27,  62,  and  45  respectively ;  but  still  this 
figure  of  283,  placed  opposite  to  a  mortality  of  699 
deaths,  is  very  distressing.  It  shows  conclusively  that 
we  should  redouble  our  efforts  to  obtain  a  vigorous  exe- 
cution of  every  prophylactic  measure  recommended  to 
the  regiments  and  field  hospitals.  But  permit  me  to 
inform  your  Excellency,  that  in  passing  among  the  regi- 
ments, I  daily  observe  that  many  of  the  tents  are  not 
ventilated,  that  the  clothing  is  rarely  spread  in  the  sun, 
and  that  the  ground  has  not  yet  received  the  sprinkling 
of  lime  ordered.  I  either  find  the  men  absent,  and  the 
tents  carefully  closed,  with  large  stoves,  so  as  to  be 
air-tight,  or  they  are  squat  smoking  within  them,  like 
Laplanders,  exposed,  without  their  knowing  it,  to  the 
danger  of  reciprocal  miasmatic  poisoning ;  and  yet,  dur- 
ing the  last  fifteen  days,  the  sun  has  not  failed  to  vivify 
the  earth  daily  with  his  presence. 

"  In  the  field  hospitals,  the  measures  directed  are  not 
executed  as  rapidly  as  I  could  wish,  but  still  progress  is 
made.  The  isolation  of  typhic  patients  has  become 
almost  complete,  the  bedsteads  have  arrived,  and  disin- 
fection by  chlorine  fumigation  is  becoming  general.  Two 


THE   CRIMEAN    WAR.  191 

field  hospitals  will  be  abandoned,  according  to  your 
orders,  on  account  of  infection,  as  soon  as  those  which 
your  Excellency  ordered  are  finished. 

"  I  regard  it  as  a  most  urgent  measure,  that  the  non- 
typhic  patients  should  be  immediately  sent  off.  At  least 
fifty  cases  of  typhus  show  themselves  daily  in  our  field 
hospitals,  among  those  entered  for  other  diseases.  This 
amounts  to  1,500  cases  per  month,  of  whom  it  is  shown, 
by  actual  results,  that  1,000  prove  fatal.  It  would  there- 
fore be  1,500  per  month  to  strike  out,  if  in  our  own 
field  hospitals  there  were  only  sick  belonging  to  this 
category.  We  should  establish  small  hospitals  in  tents, 
at  least  three  hundred  yards  from  the  actual  field  hospi- 
tals, for  the  temporary  reception  of  new  non-typhic 
cases  which  ought  to  be  sent  away.  The  result  of  this 
measure  would  be  to  keep  up  the  morale  of  the  sol- 
diers, who  have  a  horror  of  field  hospitals  and  the  con- 
tagion of  typhus. 

"  Whenever  the  day  arrives  in  which  we  shall  have  to 
treat  only  typhic  cases  coming  from  the  corps,  our  situa- 
tion will  be  materially  alleviated.  At  the  lowest  esti- 
mate, the  corps  furnishes  us  daily  seventy  men  infected 
with  the  epidemic ;  the  recoveries  and  the  deaths  would 
very  nearly  balance  this  number,  even  in  the  present 
conditions. 

"  I  have  already  had  the  honor  of  showing  your  Excel- 
lency that  by  retaining  in  the  Crimea  all  those  men 
infected  with  the  typhus,  we  should  relieve  the  fleet  and 
the  hospitals  at  Constantinople  from  the  dangers  of  infec- 
tion. I  advised  regimental  physicians  to  redouble  their 
vigilance  to  prevent  any  typhic  patient  from  remaining 
in  the  regimental  infirmaries.  The  only  danger  which 
threatens  us  is,  the  spread  of  the  epidemic  among 
the  masses.  It  may  be  prevented  by  two  different 
methods. 

"  1st.  By  continuing  to  remove  from  the  corps,  and 
sending  to  the  field  hospitals,  those  that  show  the  first 
symptoms  of  the  epidemic,  with  the  object  of  arresting 
its  propagation  by  infection. 

u  2d.  In  removing  from  the  regiments  the  causes 
which  spontaneously  generate  typhus.  This  may  be 


192  THE    CRIMEAN  WAR. 

done  by  causing  to  be  put  into  effect  the  prophylactic 
measures  laid  down  in  the  army  orders,  and  remember- 
ing that  the  most  important  of  these  measures  is  the 
change  of  site  of  the  camps  from  those  places  where  the 
disease  has  been  engendered. 

"The  urgency  of  this  latter  rule  will  appear  more 
especially  towards  the  time  when  the  troops  are  to  em- 
bark on  their  return  to  France.  It  will  be  necessary, 
at  least  fifteen  days  before  that  time,  to  make  short 
marches  with  their  shelter-tents,  and  change  their 
encampments  every  two  or  three  days.  The  country 
all  along  the  ridge  of  the  heights,  which  border  upon 
the  sea  between  Balaclava  and  Kamiesch,  presents,  in  a 
hygienic  point  of  view,  favorable  bivouacs  for  this  pur- 
pose. I  am  well  aware  that  these  frequent  movements 
must  be  irksome,  and  even  vexatious,  to  those  who  do 
not  see  their  importance ;  but  the  soldier,  who  alone 
with  the  physicians  bears  all  the  burdens  of  typhus,  will, 
with  them,  heartily  approve  of  it. 

"  If  this  advice  is  not  followed,  typhus  will  propagate 
itself  on  board  ship ;  and  as  there  will  be  no  means  of 
isolating  the  infected,  and  the  epidemic  might  assume 
gigantic  proportions,  a  heavy  responsibility  would  rest 
on  the  physician  who  has  not  warned,  and  on  the  com- 
mander who  heeds  not  the  counsels  given. 

"  The  typhus  will  continue,  so  long  as  the  causes  that 
generate  it  remain ;  and  the  danger  of  not  crushing  it  in 
the  bud,  and  of  letting  it  increase,  is — that  when  once 
started,  it  develops  itself  rapidly  by  infection,  and 
extends  to  the  masses.  Who  does  not  remember  the 
lamentable  narratives  of  misfortunes  occasioned  by  con- 
tagious typhus  in  armies  ? 

"  It  is  because  I  am  thoroughly  convinced  that  these 
misfortunes  will  not  occur,  if  we  seek  to  avoid  them, 
that  I  insist  so  much — not  so  much  to  enlighten  your 
Excellency,  whose  great  wisdom  and  experience  are 
known  throughout  the  army,  as  to  convince  these  men, 
whom  I  see  ignorant  of  the  most  elementary  principles 
of  hygiene,  living  careless  of  the  present,  and,  as  it 
were,  wrapping  themselves  up  in  a  kind  of  Mahomedan 
fatalism. 


THE   CRIMEAN   WAE.  193 

"Are  we  to  be  frightened  by  it?  Certainly  not. 
Fear  is  a  bad  counsellor ;  but  we  must  watch  and  fore- 
see. By  so  doing,  we  are  certain  never  to  be  unpre- 
pared, and  we  command  the  situation,  whatever  it  may 
be.  Supposing  the  typhus  did  not  exist,  there  would 
still  be  advantage  in  religiously  observing  the  hygienic 
rules  which  insure  the  health  of  armies. 

"  As  for  myself,  I  am  reassured ;  because  I  have  con- 
fidence in  the  enlightened  and  active  concurrence  of  the 
commanders,  and  in  the  wisdom  of  the  measures  already 
adopted  by  the  Minister  of  War.  The  personal  service 
of  the  medical  department  continues  to  sustain  losses 
daily,  but  its  courage  and  self-denial  increase  with  the 
emergency.  I  have  taken,  with  the  Intendant-general, 
certain  measures,  of  a  tendency  to  modify  this  state  of 
things,  which  grieves  me  seriously.  I  intend  to  return 
with  the  mail  of  the  5th  of  April  to  Constantinople, 
where  my  presence  may  be  of  more  use  than  in  the  Cri- 
mea ;  but  before  my  departure,  I  respectfully  beg  your 
Excellency  to  give  your  advice,  which,  shall  be  my 
command." 

On  the  30th  of  March,  the  Marshal  replied : — 

"  Since  the  measures  recommended  to  be  put  into 
execution,  in  your  report  of  the  15th  instant,  have  not 
been  performed  with  all  the  care  that  was  desirable  in 
the  several  corps,  I  will  again  call  the  attention  of  the 
general  officers  to  them.  I  will  also  carry  into  execu- 
tion, as  soon  as  the  weather  permits,  your  suggestions 
relative  to  encamping  the  troops  for  some  time  upon 
new  grounds,  and  under  the  shelter-tents.  As  for  your 
departure  for  Constantinople,  you  are  a  better  judge 
than  myself  of  its  expediency ;  and  I  leave  you  entirely 
free  to  embark  by  the  mail  of  April  5th,  if  you  deem 
your  presence  more  useful  at  Constantinople  than  in  the 
Crimea." 

An  improved  condition  of  aifairs  appeared,  and  on 
the  5th  of  April  the  Minister  of  War  wrote  to  me  as 
follows : — 

"  MY  DEAR  DOCTOR — I  do  not  thank  you  again  for 
the  care  which  you  have  taken,  for  the  zeal  which  you 
display  in  the  interests  of  our  poor  sick ;  it  would  only 


194  THE    CRIMEAN   WAR. 

be  repetition.  I  agree  with  you  that  we  should  hasten 
to  remove  our  unhealthy  camps,  placed  upon  grounds 
infected  with  miasms,  and  go  as  soon  as  possible  to  the 
heights  that  you  have  mentioned.  I  count  upon  the 
solicitude  of  Marshal  Pelissier  to  give  at  once  orders  to 
this  effect.*  We  are  much  engaged  with  matters  relat- 
ing to  the  return  of  the  army  to  France.  The  numerous 
cases  of  typhus  which  have  appeared  at  Marseilles,  at 
Toulon,  and  on  board  our  ships,  are  of  a  nature  to  cause 
us  serious  reflections.  I  have  pointed  out  to  General 
Rostolan  that  wre  have  at  the  Island  of  St.  Marguerite 
a  hospital  for  four  or  five  hundred  sick,  and  also,  under 
barracks  or  tents,  beds  for  four  or  five  thousand  men. 
At  Frioul,  where  we  have  already  a  hospital,  I  shall 
establish  a  camp  for  four  or  five  thousand  men.  Lastly, 
in  one  of  the  islands  of  Hyeres,  on  the  peninsula  of  Gyen, 
I  am  establishing  a  third  hospital  and  three  camps,  for 
ten  or  twelve  thousand. 

"Our  ships  will  disembark  their  sick  or  healthy  at  one 
or  another  of  these  establishments. 

"  The  healthy  will  remain  eight  or  ten  days,  longer  if 
necessary,  in  camp  ;  they  will  walk  about,  bathe,  will  be 
well  fed,  will  see  the  coasts  of  France ;  and,  finally,  all 
the  conditions  for  restoration  to  health  will  be,  as  far  as 
possible,  combined.  After  undergoing  this  kind  of  qua- 
rantine, those  who  have  sustained  the  test  may  be  taken 
to  Marseilles  or  Toulon,  and  sent  to  their  proper  garri- 
sons. These  are  the  measures  which  are  being  studied 
at  this  time.  The  results  of  the  inspection  you  have 
made,  in  the  localities  that  I  have  indicated,  are  very 
useful  to  us." 

*  "We  know  that  the  Marshal  only  awaited  the  return  of  fine 
weather,  which  would  dry  the  ground  deeply  soaked  by  the  winter 


THE   CRIMEAN   WAR.  195 

CHAPTER    IV. 
THE   RETURN    OF   THE   ARMY. 

PEACE  at  length  came,  putting  an  end  to  our  miseries. 
The  relations  between  the  allied  armies  and  the  Rus- 
sians were  soon  established  upon  a  very  cordial  footing, 
and  on  each  side  they  celebrated,  with  fraternal  liba- 
tions, the  termination  of  their  long-continued  sufferings. 
The  Russians,  French,  English,  and  Sardinians,  were  to 
be  seen  walking  arm  in  arm,  singing  and  dancing,  assist- 
ing each  other  to  walk  when  they  had  taken  a  glass  too 
much,  as  often  happened,  and  giving  them  a  hospitable 
couch  for  the  night,  whenever  unsteady  limbs  rendered 
it  impossible  for  their  visitors  to  depart.  The  Russian 
General,  Commander-in-Chief  of  the  division  encamped 
near  Belbec,  in  speaking  of  this,  said  to  me  :  "We  have 
had  some  Zouaves  for  several  days  in  our  camps,  who 
agree  perfectly  with  our  soldiers ;  by  the  aid  of  a  very 
simple  pantomime,  they  understand  one  another  won- 
derfully, and  drink  together  gaily.  These  Zouaves 
expect  to  be  punished  upon  their  return  to  camp,  and 
have  asked  me  for  a  certificate,  showing  that  they  were 
so  well  received  that  it  was  impossible  for  them  to  return 
to  their  regiment." 

Steeple  chases  and  military  fetes  were  held  in  the  val- 
ley of  the  Tchernai'a,  and  the  Arabian  horses  sustained 
their  ancient  reputation.  In  1856,  as  in  1855,  they 
resisted  the  rigors  of  winter  and  the  hardships  of  the 
bivouac  much  better  than  horses  of  other  breeds,  thus 
justifying  the  assertions  of  General  Dumas.*  The  races 
attracted  large  crowds,  the  soldiers  attended  without 
arms,  and  these  reunions  created  a  happy  diversion  of 
the  spirits,  which  were  depressed  with  apprehensions  of 
the  typhus.  Moreover,  dramatic  artists  from  France 

*  It  will  be  remembered,  that  in  different  essays  printed  in  the 
Revue  des  Deux  Mondes  (numbers  for  December  1,  1851,  and  May  15, 
1855),  General  Dumas  first  advocated  the  advantages  of  Arabian 
horses  for  the  purposes  of  war. 


196  THE   CRIMEAN    WAR. 

gave  very  well  attended  exhibitions,  every  evening,  in 
the  theatre  at  Karaiesch,  which  prompted  the  formation 
of  rival  companies  among  the  soldiers  themselves.  They 
compared  the  merits  of  the  young  chief  actress  at  Ka- 
rniesch  with  those  of  a  young  Zouave  bugler,  and  the 
opinions  of  critics  were  much  divided.  Had  not  most 
of  the  lyric  heroes  of  the  latter  been  slain  in  the  storm- 
ing of  the  Malakoff,  it  was  thought  that  the  theatre  at 
Kamiesch  could  never  have  competed  with  that  of  the 
Zouaves. 

In  the  bivouacs  established  upon  the  plains  of  Fedou- 
chine,  an  immense  ball-room  was  made,  where  figured 
the  grand  dames  lately  made  wealthy  in  the  villages  of 
Pickpocketville  and  Rogueville. 

Before  leaving  the  Crimea,  I  visited  once  more,  in 
company  with  Sir  John  Hall,  the  hospitals  of  our  allies, 
and  learned  with  certainty  that  the  typhus  had  not  reap- 
peared since  1855.  In  the  port  of  Balaclava,  I  visited 
an  English  steam  frigate,  fitted  up  as  a  hospital ;  it  was 
arranged  like  a  large  ward,  with  300  beds.  They  had 
carried  attention  to  the  wants  of  their  sick  so  far  as  to 
place  three  or  four  cows  on  board,  so  as  to  have  fresh 
milk  during  the  passage.  I  inquired  of  the  commandant 
how  many  troops  a  vessel  of  this  size  could  transport, 
and  he  replied,  "  700  English,  or  1,500  French,  because 
the  latter  wrill  quarter  themselves  anywhere,  either  on 
the  deck,  or  between  decks."  The  care  which  the 
English  take  of  their  soldiers,  reminds  me  of  the  expres- 
sion often  used — "  the  English  soldier  is  capital."  This 
does  not  exclude  from  them — far  from  it — sentiments  of 
humanity^  but  it  attaches  an  idea  of  value,  which 
should  be  preserved.  On  another  occasion,  when  they 
captured  at  Balaclava  a  Russian  officer  and  his  family, 
an  English  general  said,  "  Here  is  a  good  Bank  Note." 
The  French  navy  had  also  some  steam  frigates  trans- 
formed into  hospitals  ;  but  the  transportation  of  the 
sick  was  done  by  comm'on  merchant  steamers  or  sailing 
vessels.  The  ships  of  the  imperial  postal  service  were 
particularly  useful  in  this  capacity.  The  sick  had  each 
of  them  a  little  mattress  and  a  blanket. 

From   a   general   statistical   account,    published    in 


THE    CRIMEAN    WAR.  197 

England  by  the  Minister  of  War,  Lord  Panmure,  it 
appears  that  from  the  19th  of  September,  1854,  to  the 
28th  of  September,  1855,  the  English  army  had  188 
officers  "and  1,775  soldiers  killed.  There  died  of  wounds, 
during  the  same  period,  51  officers,  and  1,548  soldiers; 
of  cholera,  35  officers,  and  4,244  soldiers;  and  of  other 
diseases,  up  to  the  end  of  December,  1855,  26  officers, 
and  11,425  men.*  These  severe  trials  did  not  recur, 
and  during  the  year  1856,  the  sanitary  condition  of  the 
English  army  was  in  a  very  satisfactory  state,  even  in 
the  depth  of  winter.f  To  be  convinced  of  this,  it  is  only 

*  Since  the  above  period,  and  up  to  March  31,  1856,  322  soldiers 
have  died  of  wounds  and  diseases,  making  a  total  of  270  officers  and 
19,314  men.  In  addition  to  these,  2,873  soldiers  were  frozen,  making 
a  total  of  22,457  deaths. 

During  the  winter  of  1854-5  (from  the  1st  of  October  to  the  30th  of 
April,  a  period  of  seven  months),  the  mortality  in  the  English  army 
was  distributed  as  follows: — 

Infantry,  39  deaths  per  100  men  in  seven  months. 

Artillery,  18      "  "  4i 

Cavalry,  15      "  "  " 

Naval  brigade,  4      " 

Officers  of  all  arms,    6      " 

AUTHOR'S  NOTE. 

f  At  an  early  period  in  the  war,  the  English  army  had  suffered  con- 
siderably from  disease ;  but  this  was  remedied  by  a  vigorous  adminis- 
tration towards  its  close.  During  its  occupation  of  Bulgaria,  in  the 
early  part  of  1854,  cholera,  diarrhoea,  and  dysentery  made  great  havoc. 
The  troops  arrived  before  Sebastopol,  debilitated  by  these  diseases  and 
the  influences  that  had  caused  them,  and  were  for  weeks  without  tents 
or  changes  of  clothing.  The  supplies  arriving  at  a  later  period,  left 
few  causes  of  disease  beyond  those  incident  to  the  climate  and  the 
labors  and  exposures  of  the  men. 

Of  fevers  (not  typhus),  30,376  cases  and  3,161  deaths  occurred.  Their 
greatest  prevalence  was  in  March,  1855,  when  they  gave  21  per  cent, 
of  the  mortality  of  that  month.  The  kind  of  fever  that  most  prevailed 
in  the  English  army  partook  of  the  character  of  typhoid  fever,  as  seen 
in  large  cities,  and  showed  an  absence  of  great  febrile  action — a  rapid 
prostration,  slow  convalescence,  and  tendency  to  relapse.  It  was  often 
followed  by  dysentery,  and  the  intestinal  lesions  which  attended  it 
occasioned  secondary  diseases  that  often  proved  fatal,  especially  if  the 
patient  exposed  himself  to  irregularities  of  diet,  or  the. use  of  intoxi- 
cating drinks,  during  the  period  of  apparent  convalescence.  It  was 
not  imcommon  for  the  febrile  symptoms  to  disappear  entirely,  and 
prospects  of  health  to  gradually  return,  so  as  to  admit  of  discharge 
from  the  hospital.  But  at  a  period  more  or  less  remote,  a  fresh  inva- 


198  THE   CRIMEAN   WAK. 

necessary  to  read  the  weekly  bulletin  given  to  me  by  Sir 
John  Hall,  upon  the  day  that  I  paid  him  a  visit,  March 
25th,  1856. 

Weekly  Report,  from  the  16th  to  the  22d  of  March. 

Effective  strength  of  the  English  army  in  the  Crimea  and  at 

Constantinople 70,042 

Entered  the  hospitals  and  regimental  infirmaries 1,883 

Sent  oft',  or  discharged  cured 1,641 

Died 25 

Keinaining  in  the  general  and  field  hospitals 4,267 

Proportion  of  sick  to  effective  strength 6.09  per  cent. 

Proportion  of  deaths  to  effective  strength. . .  .0.03  per  cent. 

The  return  of  fine  weather  dried  the  soil  of  the 
Crimea,  and  permitted  us  at  length  to  remove  the 
location  of  the  camps  to  new  and  non-infected  ground. 
The  necessities  of  the  war  did  not  require,  after  the 
treaty  of  March  30th,  any  of  the  regiments  to  re- 
main and  hold  the  military  positions  of  the  left 
bank  of  the  Tchernaia,  with  its  miasmatic  emanations ; 
Marshal  Pelissier  issued  orders  to  abandon  the  old 
bivouacs,  and  remove  three  leagues  to  the  south,  upon 
the  high  plateaux,  ventilated  by  the  sea  breeze,  and 
inclining  from  the  monastery  of  St.  George  towards 
Kamiesch.  All  of  the  barracks  and  large  tents,  conta- 
minated by  prolonged  habitation,  were  replaced  by 
Marshal  Bugeaud's  little  shelter-tents.  The  sites  of  the 
camps  were  frequently  changed,  and  these  migrations 
every  time  effected  an  improvement  in  the  health  of  the 
troops.  Such  removals  often  excited  remonstrances  on 
the  part  of  officers,  who  were  continually  disturbed  in 

sion  of  the  disease  was  very  apt  to  occur ;  and  after  an  uncertain  con- 
tinuance, with  favorable  remissions,  death  would  in  three  or  four 
months,  if  not  sooner,  close  the  scene.  This  fever  was  known  as  the 
"Crimean  fever,"  and  was  never  absent  from  the  English  army  during 
the  campaign. 

Typhus  fever  proper,  which  made  such  frightful  havoc  hi  the  French 
army,  occurred  among  the  English  troops  in  828  cases,  of  which  285 
were  fatal.  It  prevailed  chiefly  in  the  spring  of  1855,  and  presented 
the  usual  appearances  of  the  disease  in  England.  The  Russians  suf- 
fered from  the  typhus  even  more  terribly  than  the  French — Tu. 


THE   CRIMEAN   WAR.  199 

their  arrangements.  The  Marshal,  however,  took  no 
notice  of  them  ;  he  cared  .only  for  the  health  of  the  sol- 
diers. He  presided  at  the  embarkation  of  the  troops, 
watching  that  no  regiments  should  be  embarked  but 
those  in  which  traces  of  typhus  had  not  appeared  for 
some  weeks ;  and  did  not  himself  leave  the  soil  of  the 
Crimea  until  the  last  regiment  had  departed. 

On  the  8th  of  April,  1856, 1  left  the  Crimea.  M.  Scrive, 
the  physician-in-chief,  with  an  enlightened  solicitude, 
superintended  and  put  into  vigorous  execution  the 
hygienic  measures  which  I  had  advised.  Twice  a  week 
he  sent  me  a  bulletin  of  the  sanitary  state  of  the  army 
before  Sebastopol.  Upon  my  arrival  at  Constantinople, 
on  the  llth  of  April,  I  found  still  in  the  hospital  three 
or  four  thousand  cases  of  scurvy,  and  of  8,315  sick,  there 
were  1,379  typhic  patients.  The  mortality  during  the 
last  ten  days  had  only  been  620,  showing  a  reduction 
of  more  than  a  third  upon  the  numbers  for  the  pre- 
ceding period  of  ten  days.  The  Russian  prisoners  hav- 
ing just  left  the  island  of  Prinkipo,  I  visited  it  on  the 
day  after  my  arrival,  and  found  a  perfectly  salubrious 
site,  which  the  Russians  had  not  occupied.  It  was  easy 
to  establish  there  three  hundred  tents  upon  the  border 
of  a  pine  wood,  and  I  designed  sending  thither  a  part  of 
the  scorbutic  inmates  of  our  hospitals.  At  the  rate  of 
six  men  to  a  tent,  this  would  accommodate  1,800  patients, 
and  I  laid  the  plan  before  Marshal  Pelissier.  "  The  ar- 
rangement," said  I,  "  would  be  simple ;  some  boards  laid 
together  a  few  inches  from  the  ground  would  serve  as  a 
floor  and  camp  bed,  and  some  mattresses,  or,  if  these 
are  wanting,  some  straw  beds,  with  pillows,  bed  cloth- 
ing, and  blankets,  will  complete  the  furniture  of  this 
temporary  establishment.  The  country  air,  now  fresh- 
ened with  vegetation;  the  liberty  of  running  in  the 
woods,  and  of  fishing  on  the  sea-shore;  and  a  diet 
largely  vegetable,  would  yield  results  which  we  must 
never  expect  in  our  hospitals.  I  estimate  that  we  could 
send  monthly  to  Prinkipo  1,800  new  scorbutic  cases. 
We  will  not  send  the  convalescents  to  France  until  they 
have  undergone  a  month  of  this  salutary  quarantine ; — 
thus  easily  and  certainly  escaping  the  invasion  of  typhus 


200  THE   CRIMEAN    WAR. 

upon  the  voyage.  Thanks  to  this  increase  ol  our 
resources,  we  may  insure,  without  further  interruption, 
the  indispensable  separation  of  typhic  and  non-typhic 
patients.  We  might  intrust  the  attendance  of  these 
1,800  scorbutic  cases  to  the  eight  Crimean  physicians 
who  are  at  this  time  recovering  from  typhus  at  the  con- 
valescent hospital  prepared  for  them  at  Sebastopol.  If 
we  persist  in  the  salutary  measure  of  sending  to  Con- 
stantinople all  the  sick  not  infected  with  the  typhus,  the 
personal  attendance  of  the  medical  service  of  the  Crimea, 
although  so  reduced  by  the  epidemic,  will  nevertheless 
be  more  thar  sufficient,  and  a  portion  can  be  spared  to 
return  to  Constantinople.  As  for  the  eight  convalescent 
physicians,  they  will  not,  for  a  long  time  to  come,  be 
exposed  to  new  dangers  from  the  infection  of  typhus. 
At  Prinkipo,  in  making  the  tour  of  visitation,  they 
would  regain  their  health  at  the  same  time  as  they  were 
restoring  it  to  their  scorbutic  patients." 

On  the  14th  of  April,  the  Marshal  replied: — "I  ap- 
prove the  putting  into  execution  of  this  project,  and  by 
this  mail  give  the  necessary  instructions."  I  at  once 
went  to  Prinkipo,  to  prepare  a  large  field  hospital  for 
1,800  scurvy  patients ;  and,  thanks  to  the  energy  of 
General  Pariset,  who  succeeded  General  Larchey  in  the 
command  of  the  post  at  Constantinople,  I  completed 
this  task  in  two  or  three  days.  Prinkipo  took  the  place 
of  Mytilene.  Scarcely  had  the  sick  arrived,  than  they 
recovered  their  health,  and  were  soon  wandering  over 
the  island,  elated  and  joyous. 

On  my  way  to  Prinkipo,  I  stopped  at  Calchi,  a  neigh- 
boring island,  where  there  was  one  of  the  two  hospitals 
assigned  to  the  naval  service,  the  other  being  on  the 
Bosphorus.  Both  were  very  admirably  conducted  by 
clever  physicians.  In  front  of  Calchi  there  lay  at  anchor 
four  or  five  large  ships  of  war,  which  bore  the  yellow 
flag  of  the  quarantine.  They  had  been  infected  by  the 
typhus  in  consequence  of  having  transported  the  sick 
from  the  Crimea.  A  part  of  their  crews,  affected  with 
this  disease,  had  been  landed,  and  were  very  well  pro- 
vided for,  in  immense  rooms  converted  into  hospitals,  or 
in  double  tents.  Immediately  on  my  return  to  Constan- 


THE   CRIMEAN   WAR.  201 

tinople,  I  effected  the  isolation  of  all  the  sick  infected 
with  the  typhus,  and  a  daily  renewal  of  the  bed  cloth- 
ing; the  number  of  new  cases  appearing  within  the 
twenty-four  hours  fell  at  once  to  half  the  former  num- 
ber. Thanks  to  the  mildness  of  the  temperature,  we 
were  able  to  put  in  tents  the  typhic  patients  belong- 
ing to  the  hospitals  extra-muros,  thus  securing  a  com- 
plete isolation  and  constant  ventilation.  The  ships  had 
still  among  their  crews  a  number  of  typhic  cases  ;  and 
on  the  14th  of  April,  fourteen  sailors,  who  belonged  to 
a  ship  that  had  been  selected  to  transport  300  conva- 
lescent sick,  were  sent  to  the  hospital.  The  order  for  its 
departure  was  at  once  countermanded.  I  directed,  in 
all  the  ships  freighted  by  the  government,  an  active  sur- 
veillance to  be  instituted,  and  thorough  hygienic  and 
disinfecting  measures  to  be  adopted.  I  conferred  with 
Dr.  Fauvel,  quarantine  physician,  who  stated,  that  he 
had  no  directions  to  add  to  those  which  I  had  advised 
and  caused  to  be  put  into  effect.  If  the  measures  begun 
were  thoroughly  carried  out,  the  typhus  would  speedily 
disappear.  During  the  whole  course  of  the  epidemic, 
the  population  of  Constantinople  escaped  the  disease ; 
nor  did  they  evince  any  disquietude,  being  in  this  respect 
wiser  than  the  inhabitants  of  the  South  of  France,  who 
were  alarmed  beyond  measure  at  the  importation  of  the 
pestilence  through  the  arrival  of  typhic  cases  at  Mar- 
seilles and  Toulon.  The  Turkish  government  placed  at 
our  disposal,  as  auxiliaries,  the  most  proficient  students 
in  their  medical  school,  and  the  aid  thus  rendered  gave 
us  a  very  satisfactory  idea  of  the  organization  of  the 
medical  corps  of  the  Ottoman  government.  The  direc- 
tor of  the  health  service  of  the  Turkish  army  was  Tho- 
mal-Bey,  a  very  important  personage,  and  grand  judge 
of  Anatolia.  This  dignity  corresponds  with  the  rank  of 
Muchir,  or  pacha  of  three  tails.  The  generals  of  division 
are  only  pachas  of  two  tails. 

This  high  functionary  is  also  Director  of  the  School 
of  Military  Medicine,  into  which  they  admit  students 
from  civil  life.  He  presides  twice  a  week  at  the  council, 
composed  of  the  professors,  and  labors  directly  with  the 
Minister  of  War.  The  sub-director  of  the  school,  Arif- 

10 


•    I 


202  THE   CRIMEAN   WAR 

Bey,  superintends  the  health  service,  and  daily  addresses 
a  written  report  to  the  director.  These  health  officers 
of  the  Turkish  service,  like  the  military  staff  of  almost 
all  other  nations,  have  a  line  of  grade  and  promotion 
corresponding  with  the  officers  of  the  army.  In  the 
Turkish  army,  all  the  chief  physicians  of  the  great  hos- 
pitals have  the  rank  of  colonel,  and  their  pay  is  even 
higher  than  that  of  those  officers.  The  other  physicians 
have  the  ranks  of  lieutenant-colonel,  chief  of  battalion, 
and  captain.  The  latter  grade  is  borne  only  by  a  small 
number  of  the  military  medical  officers. 

In  the  last  days  of  February,  at  the  close  of  a  con- 
ference upon  the  subject  of  typhus,  at  wrhich  the  medical 
personnel  of  the  hospitals  of  the  military  school  attended, 
an  English  physician,  Mr.  Pinkoffs,  who  has  distin- 
guished himself  by  his  great  zeal  for  science,  proposed 
to  me  an  early  convention  of  the  English  and  Sardinian 
physicians.  The  idea  at  that  time  occurred  to  me  to 
found  a  Medical  Society,  which  should  continu^  after 
our  departure,  by  interesting  in  it  the  more  eminent 
physicians  of  Constantinople  and  the  professors  of  the 
Turkish  Medical  School,  among  whom  was  our  learned 
countryman,  M.  Fauvel,  quarantine  surgeon.  Mr.  Pin- 
koffs seconded  me  willingly,  and  took  all  the  necessary 
steps,  which  resulted,  soon  after  our  departure,  in  the 
foundation  of  a  society,  with  an  annual  stipend  from  the 
Sultan,  and  called  the  Imperial  Medical  Society.  I 
recur  with  pleasure  to  the  time  when,  during  my  sojourn 
at  Constantinople,  I  presided  at  this  assembly  of  distin- 
guished savans.  The  sessions  of  the  new  society  were 
taken  up  by  lectures  and  important  discussions,  and  the 
medical  press  at  Paris  still  continue  to  publish  its  trans- 
actions. As  early  as  1 830,  I  had  had  the  good  fortune 
to  revive  in  Algeria  the  course  of  studies  of  the  Avi- 
cenne,  the  Razes,  the  Albucasis,  &c.,  which  had  been 
interrupted  for  centuries ;  and  it  was  with  this  idea  that 
I  co-operated  in  the  formation  of  the  first  learned  society 
in  Stamboul. 

Upon  becoming  assured  of  the  good  effect  of  the 
measures  adopted  to  counteract  the  epidemic,  happily 
on  the  decline,  I  was  desirous  of  completing  my  investi- 


THE   CRIMEAN   WAF.  203 

gallons  of  the  medical  institutions  of  Turkey  by  a  visit 
to  their  hospitals  at  Constantinople.  The  Ottoman  go- 
vernment had  reserved  for  its  own  use  four  military 
hospitals,  located  at  the  Seraskierat,  at  Jeni  Batche 
(new  garden),  at  Gulhane,  and  at  the  Navy  Office ;  the 
remainder  having  been  generously  placed  at  the  disposal 
of  the  allied  armies.  The  French  occupied  those  on  the 
European  shore,  and  the  English  the  fine  military 
edifices  at  Scutari,  on  the  Asiatic  side.  All  of  these 
hospital  establishments,  built  upon  elevated  and  salu- 
brious sites,  and  as  much  isolated  from  other  habitations 
as  a  ship  in  quarantine,  are  a  perfect  acknowledgment 
of  sanitary  laws.  A  great  number  of  openings  ad- 
mitted the  air  and  light ;  the  windows  were  double,  to 
prevent  the  sick  near  them  from  being  incommoded  by 
currents  of  air  through  the  joints,  and  to  allow  a  genial 
temperature  to  be  easily  maintained  in  winter.  Green 
curtains  tempered  the  light,  often  too  strong  in  this 
oriental  region.  On  a  level  with  the  ground,  openings 
made  through  the  external  walls  ventilate  the  lower 
part  of  the  rooms.  The  floors  were  painted  in  oil,  or  so 
thoroughly  washed,  that  not  a  speck  of  dirt  could  be 
seen.  Narrow  strips  of  carpet,  placed  along  the  foot  of 
the  bed  and  the  spaces  between  them,  deadened  the 
footsteps  of  the  attendants.  Smoking  was  strictly  for- 
bidden ;  convalescents  could  only  smoke  in  the  rooms 
specially  reserved  for  this  purpose.  Excepting  in  some 
of  the  minor  details,  there  was  everything  to  praise. 
The  beds  appeared  to  me  to  be  rather  too  near  each 
other — the  sick  do  not  get  air  enough  to  breathe.  This 
fault  is  in  part  obviated  by  the  unexpected  extreme 
cleanliness,  and  by  the  custom  of  keeping  the  doors  and 
windows  open.  The  mildness  of  the  climate  prevented 
those  dangers  which  would  have  attended  such  a  mea- 
sure in  France.  The  rooms  are  warmed  in  winter,  and 
most  of  the  windows  open  on  to  great  inclosed  galleries, 
where  the  temperature  is  never  very  low.  Fumigations 
of  chlorine,  and  especially  of  aromatic  herbs,  are  repeated 
several  times  a  day  in  all  the  rooms,  carrying  away  the 
loathsome  miasms  generated  by  the  sick — a  practice 
which  I  wrould  wish  to  see  introduced  into  the  hospitals 


204  THE   CRIMEAN   WAR. 

in  France,  as  it  already  has  been  into  our  general  and 
field  hospitals  in  the  East. 

The  privies,  placed  in  isolated  sheds,  communicate 
with  the  rooms  by  covered  passages,  and  are  paved  with 
large  blocks  of  marble  kept  always  clean.  A  great  num- 
ber of  small  swinging  windows,  opening  at  the  top, 
secured  constant  ventilation.  Most  of  the  bedsteads 
were  of  iron,  and  the  mattresses,  the  clothing,  and  the 
blankets  were  of  irreproachable  cleanliness.  Upon  the 
night  stand  of  each  patient  is  placed  a  tray  of  tinned 
copper,  holding  a  dish  of  drink,  a  plate,  and  a  spit-box, 
so  as  not  to  soil  the  floors.  These  articles,  which  were 
of  zinc,  were  kept  very  bright.  A  little  board,  fixed  to 
the  table,  bore  the  number  of  the  bed,  the  name  of  the 
patient,  his  disease,  and  the  prescription  of  diet  for  the 
day.  The  apothecary  wrote  upon  a  separate  memoran- 
dum book,  at  the  dictation  of  the  physician,  the  medi- 
cines which  he  was  to  administer.  The  hospital  costume 
consisted  of  pantaloons,  cap,  slippers,  <fcc. 

The  arrangements  for  washing  would  be  an  object  of 
envy  to  our  good  Flemish  housewives.  Basins  of  white 
marble,  attached  to  the  walls,  were,  like  our  bathing 
tubs,  furnished  with  pipes  for  supplying  the  water  and 
letting  it  out  after  it  had  been  used.  The  articles  to  be 
washed  are  soaked  in  large  coppers,  in  which  wood 
ashes*  are  macerated.  In  rainy  weather,  in  winter, 
they  exposed  the  linen  upon  driers,  placed  over  large 
braziers.  These  prudent  measures,  so  essential  in  a 
country  frequently  devastated  by  malignant  epidemics, 
prevented  the  bad  results  of  incumbrance  and  infection, 
so  frequent  in  the  hospitals  of  other  countries. 

The  diet,  appropriate  to  the  wrants  of  the  East,  is 

*  The  custom  of  wringing  clothing  to  deprive  it  of  water  is  liable  to 
tear  it  The  English,  in  their  hospitals  at  Scutari,  replaced  wringing 
by  drying  in  a  turbine.  The  wet  clothes  were  placed  in  a  kind  of 
circular  metallic  basin,  pierced  with  many  small  holes,  and  this  was 
made  to  revolve  very  swiftly  upon  its  axis  by  means  of  a  crank.  The 
linen,  obeying  the  centrifugal  law,  pressed  strongly  against  the  sides 
of  the  basin,  where  the  openings  gave  exit  to  all  the  water  contained. 
It  would  be  an  improvement  to  introduce  it  into  our  hospitals.  The 
English  call  this  ingenious  device  the  "wringing  machine/' — AU- 
THOR'S NOTE. 


THE   CRIMEAN   WAR.  205 

healthy  and  simple.  In  Constantinople,  beef  not  being 
much  esteemed,  mutton  roasted,  or  served  with  vegeta- 
bles, cabbage,  chicory,  or  rice,  forms  the  basis  of  hospi- 
tal diet.  The  lighter  form  of  diet  most  in  use,  is  a  cream 
of  sweetened  rice,  of  which  the  Turks  prepare  the  na- 
tional dish  called  Malibi.  The  sick  take  t\vo  repasts  a 
day — one  at  eight  in  the  morning,  and  the  other  at  three 
or  four  o'clock  in  the  afternoon.  The  first  is  composed 
of  a  simple  porridge,  thickened  with  rice,  and  the  second 
includes,  for  a  convalescent  man,  300  grammes  (0.57  Ibs.) 
of  cooked  meat,  some  vegetables,^ and  600  grammes 
(1.14  Ibs.)  of  bread.  This  allotment  of  food,  too  small 
for  the  first  meal,  and  too  abundant  for  the  second, 
requires  a  better  distribution. 

The  hospital  at  the  Turkish  Navy  office  presents  a 
great  luxury  of  arrangement,  and,  as  a  model,  has  no 
rival  in  any  of  the  hospitals  of  Europe.  In  the  little 
hospital  of  the  palace  of  Bachistach,  everything  is  in 
princely  style, — rich  carpets, — beds  and  curtains  of  silk, 
— choice  supplies  of  food,  and  perfect  attention  to  every 

want.  Dr.  Z ,  one  of  the  Sultan's  physicians,  who 

conducted  me  through  the  establishment,  could  not  show 
me  the  apartments  of  the  women  of  the  harem,  but  in- 
formed me  their  principal  disease  was  an  ungovernable 
jealousy,  continually  aroused  about  things  which  to  us 
would  seem  quite  unimportant.  They  receive,  from 
time  to  time,  little  gifts — for  example,  a  box  of  sugar- 
plums. The  three  or  four  hundred  boxes  must  be  ex- 
actly alike,  or  there  ensue  scenes  of  violence  that  en- 
danger their  health.  Almost  all  of  them  die  of  pulmon- 
ary consumption  at  an  early  age.  M.  Z sent  secretly 

to  the  more  feeble  of  them  some  bottles  of  Bordeaux 
wine,  to  prolong  their  existence. 

Henceforth,  the  grand  and  only  object  was  the  return 
of  the  army  to  France.  The  cases  of  typhus,  already 
imported  by  our  ships  into  Marseilles  and  Toulon,  spread 
alarm  among  the  inhabitants,  and  rendered  great  precau- 
tions necessary.  The  minister  of  war  had,  fortunately, 
taken  the  wise  sanitary  measures  which  were  stated  in  a 
foregoing  letter.  On  arriving  in  France,  the  army  of  the 
East  had  to  undergo  a  kind  of  quarantine,  in  the  hos- 


206  THE    CRIMEAN   WAR. 

pitals  and  camps,  established  at  the  Island  of  Saint  Mar- 
guerite, at  Frioul,  in  the  islands  of  Hyeres,  and  in  the 
peninsula  of  Gyen,  under  the  skilful  medical  direction 
of  M.  Maillot,  inspector  of  the  health  service  of  the 
army.  To  establish  the  series  of  hospitals  as  stages  on 
the  route  of  the  fleet,  it  was  desirable  that  there  should 
be  a  field  hospital  at  Pirea,  and  another  at  Messina.  The 
objections  raised  by  the  Neapolitan  government  pre- 
vented us  from  placing  a  hospital  for  typhic  patients  in 
Sicily.  The  ships,  laden  with  troops,  had  orders  to  leave 
the  infected  cases  at  Gallipolis,  Nazara,  Malta,  and  Cor- 
sica, before  their  arrival  in  France.  By  debarking  the 
sick  men  at  each  of  these  stations,  it  prevented  conta- 
gion from  spreading  on  board  the  transport  vessels. 

Two  other  sanitary  stations  were  necessary,  one  be- 
tween Nagara  and  Malta,  and  the  other  between  Malta 
and  Corsica.  I  went  to  Pirea  and  had  an  interview 
with  Admiral  Bouet  Willaumez,  and  with  M.  Mercier, 
the  French  Minister.  The  Grecian  Minister  of  Foreign 
Affairs,  M.  Rangabe,  gave  us  immediately  authority  to 
establish  a  hospital,  for  typhic  patients,  in  the  island  of 
Milo,  which  we  went  to  examine.  This  island  resembles, 
in  form,  a  horseshoe,  and  only  at  the  head  of  the  har- 
bor are  there  any  low  and  marshy  uninhabited  grounds. 
The  population,  numbering  about  three  thousand,  live 
in  villages  perched  upon  the  mountains.  On  the  west- 
ern side  is  Castro,  where  M.  Brest,  our  Consul,  a  fine 
old  man,  to  whom  we  are  indebted  for  the  Venus  of 
Milo,  resides.  I  selected  a  monastery,  which  had  been 
abandoned  since  1837,  at  the  time  when  monastic  pro- 
perty was  reconstituted  the  domain  of  the  Greek  govern- 
ment. Knowing,  by  tradition,  that  the  monks  always 
selected  for  themselves  the  most  salubrious  and  pleasant 
places,  I  made  an  ascent  to  this  establishment  by  a  wind- 
ing but  very  practicable  road  for  mules.  I  there  found 
some  large  buildings,  half  in  ruins,  but  which  could  be 
made  serviceable — three  or  four  fine  kitchen  gardens,  and 
some  beautiful  level  spots,  shaded  and  perfectly  adapted 
for  pitching  tents.  An  old  centenarian  and  his  family 
lived  here,  but  occupied  only  one  or  two  rooms.  Water 
was  abundant  and  of  good  quality.  It  was,  however, 


THE   CRIMEAN   WAK.  207 

difficult  to  install  three  hundred  sick  at  Milo,  and  if  in- 
fection had  spread  in  the  fleet  during  the  voyage,  this 
hospital  would  have  soon  proved  insufficient.  This  fact 
decided  us  to  sail  for  Candia,  where  the  Sultan  had  given 
us  permission  to  arrange  a  hospital  establishment.  We 
found  in  that  island  a  fine  well-aired  plateau,  which  was 
reached  by  an  easy  mule  road,  which  the  Pacha  promised 
should  be  immediately  put  in  repair.  Yely  Pacha,  for- 
merly ambassador  to  Paris,  placed  at  our  disposal,  one 
hundred  officers'  tents,  for  the  formation  of  a  hospital, 
which,  fortunately,  was  not  wanted. 

The  number  of  sick  diminished  rapidly  in  the  Crimea 
and  at  Constantinople,  the  hospitals  were  emptied  and 
closed,  and,  on  the  6th  of  June,  Marshal  Pelissier  wrote 
to  me  as  follows : 

"  You  will  doubtless  be  recalled  to  France  in  a  few 
days,  and  your  mission  to  the  army  will  then  end.  I 
will  not  let  you  leave  Constantinople,  without  express- 
ing to  you  my  satisfaction  at  the  manner  in  which  you 
have  discharged  your  duties,  and  without  informing  you 
that  I  have  made  a  statement  to  the  minister,  of  the  use- 
ful and  enlightened  services  which  you  have  rendered  to 
the  army." 

I  left  the  East  with  the  consciousness  of  having  con- 
tributed, to  the  extent  of  my  ability,  to  the  alleviation 
of  so  many  evils,  and  I  may  also  say,  of  having  witnessed 
the  most  appalling  spectacles  which  have  been  seen  for 
many  a  day.  To  the  active  instruments  of  death,  which 
human  genius  had  rendered  so  murderous,  and  which 
were  never  before  collected  in  so  great  a  number,  with- 
in so  small  a  space,  were  added  the  cholera,  the  scurvy, 
the  dysentery,  and  the  typhus.  The  constant  and  active 
solicitude  of  the  government,  the  persevering  efforts  of 
the  military  administration,  and  the  devotion  of  the 
medical  staff,  had  ended,  it  is  true,  by  conquering  the 
epidemics,  but  at  the  cost  of  what  sacrifices  !  If  we  con- 
sult the  medical  statistics  of  the  hospital  establishments, 
which  should  alone  occupy  our  attention  in  this  view, 
we  would  find  that  the  number  of  deaths  occurring  in 
the  field  and  general  hospitals  in  the  East,  during  the 
campaign,  would  amount  to  about  63,000,  of  which 


208  THE   CRIMEAN   WAR. 

31,000  occurred  in  the  Crimea,  and  32,000  at  Constanti- 
nople. 

An  army  needs  moral  excitement,  to  prevent  home- 
sickness and  prostration.  Religion  exalted  the  troops 
of  Godfrey  of  Bouillon ;  a  spirit  of  chivalry  animated 
the  French  officers  at  Fontenoy ;  the  certainty  of  victory, 
maintained  by  a  rapid  succession  of  victories,  sustained 
the  armies  of  the  Empire.  It  was  a  noble  motive  also 
which  inspired  our  troops  during  the  severe  campaign 
of  the  Crimea  ;  it  was  the  sentiment  of  duty  which  ani- 
mated our  soldiers,  without  failing  for  a  single  day,  in 
this  struggle  equally  glorious  against  the  enemy,  and 
against  privations  and  sufferings  of  every  kind.  Although 
other  armies  may  have  shown  as  .much  heroic  ardor,  im- 
petuosity, and  bravery,  as  the  army  of  the  East,  none 
have  surpassed  it  in  stoicism,  courage^  and  contempt  of 
death. 


APPENDIX. 


Economy  in  the  Use  of  Linen  for  Dressings. 

THE  Minister  of  War  sent  me,  on  the  30th  of  August, 
1855,  the  following  instructions: — 

"  At  this  time,  when  you  are  intrusted  with  the  im- 
portant service  of  Medical  Inspector  of  the  general  and 
tield  hospitals  of  the  Army  of  the  East,  I  think  it  pro- 
per to  send  you  some  instructions  relative  to  a  thorough 
examination  of  the  use  and  consumption  of  linen  for 
dressings. 

"  The  high  price  of  this  kind  of  linen,  the  scarcity  of 
materials  needed  in  its  preparation,  and  the  delays  in  its 
manufacture,  render  its  adequate  supply  very  difficult. 
It  is  therefore  highly  important,  that  the  consumption 
of  linen  for  dressings  should  be  economized,  in  order 
that  the  surgeons  may  always  be  able  to  meet  the  more 
pressing  demands  of  their  profession.  To  enable  you  to 
render  an  exact  account  in  this  regard,  I  herewith  send 
twenty  copies  of  the  instructions  of  May  12,  1845,  and 
of  the  circular  of  January  15,  1853,  relative  to  the  use 
of  these  articles.  These  documents  will  give  you  full 
instructions  as  to  the  preparation  of  the  linen  and  the 
means  employed  in  supplying  deficiencies.  You  will 
make  such  distribution  of  the  papers  as  you  may  judge 
to  be  for  the  interest  of  your  inspection. 

"  You  are  directed  to  satisfy  yourself  that  the  physi- 
cians in  charge,  in  the  establishments  you  may  visit,  use 
no  more  linen  for  dressings  than  may  be  absolutely  ne- 

10* 


210  APPENDIX. 

cessary ;  and  will  request  them  to  favor  this  end,  as  far  as 
may  be,  by  causing  it  to  be  washed  and  used  again  until 
completely  worn  out.  You  will  be  able  to  concert  mea- 
sures with  the  military  intendants,  Blanchot  and  Angot, 
for  adopting  the  most  effectual  measures  to  attain  this 
desirable  result,  through  the  concurrence  of  physicians 
and  other  accountable  persons.  In  permanent  establish- 
ments there  should  be  no  difficulty;  those  in  charge  can 
take  advantage  of  the  conveniences  offered  for  wash- 
ing. Experience  has  demonstrated  that  a  pound  of  new 
linen  may,  by  repeated  washings,  be  made  to  go  as  far 
as  six  pounds.  I  cannot  demand  that  this  proportion 
shall  be  exactly  attained  ;  but  an  active  supervision,  and 
method,  ought  to  yield  results  not  hitherto  reached. 

"  Your  arrival  in  the  Crimea  will  coincide  with  a 
measure  which  I  think  will  be  profitable  to  the  treasury 
and  facilitate  the  surgical  service,  without  the  sick  hav- 
ing to  suffer  thereby.  I  will  order,  through  the  Military 
Journal,  the  employment  of  cotton,  along  with  linen,  for 
dressing,  under  such  rules  as  may  be  furnished  by  the 
Council  of  Health.  Large  supplies  of  this  linen  will 
speedily  be  sent  to  the  regular  and  field  hospitals  of  the 
army,  along  with  the  compresses  of  carded  cotton,  of  the 
use  of  which  you  are  directed  to  explain  the  advantages. 
I  charge  you  to  use  your  influence  among  the  acting 
surgeons  to  induce  them  to  employ  willingly  these  arti- 
cles, with  the  view  of  reducing  the  demand  for  dressings 
writhin  the  limits  of  our  means  of  supply.  The  impor- 
tant subjects  brought  to  your  notice  by  the  present  dis- 
patch should  be  made  the  occasion  of  a  detailed  report 
in  your  labors  of  inspection.  The  military  intendants, 
Blanchot  and  Angot,  are  informed  of  these  instructions, 
and  are  directed  to  furnish  all  the  means  you  ma/  deem 
necessary  to  insure  the  execution  of  my  orders." 


APPENDIX.  211 


n. 

Alimentary  Regulations  of  the  Sick  in  the  Sardinian 
Army. 

\ 

THE  following  table  shows  the  common  rations  of  each 
meal  (at  ten  in  the  morning  and  four  in  the  afternoon), 
in  the  Sardinian  army,  and  was  furnished  to  me  by 
M.  Comizetti,  chief  physician  of  the  Piedmontese  army 
corps :  it  is  here  inserted  as  a  document  worthy  of 
examination : — 

ounces  ounces  ounces  ounces  ounces  pints  pints 

bread,  baked  pie  or  rice.        bread  broth,  wine, 

meat,  vermicel.  for  soup. 

Diet 1.32  1.76       3.52  0.48      

Quarter  ration  ..     2.20  0.70  1.32  1.76       3.52  0.48  1.18 

Half  ration 4.40  1.40  1.32  1.76       3.52  048  0.36 

Three-quar.  ration  6.60  2.10  1.32  1.76       3.52  0.48  0.36 

Ration* 8.80  2.80  1.32  1.76       3.52  0.48  0.36 

The  ration  of  meat  for  a  day  is  only  0.55  Ibs.,  while 
in  the  French  hospitals  it  is  double  that  quantity.  It 
would  not  be  enough  to  make  a  good  broth  ;  but  they 
add,  like  the  English,  the  juice  of  preserved  meats,  called 
"  essence  of  beef."  The  distribution  of  food  commonly 
takes  place  twice  a  day,  at  ten  in  the  morning  and  at 
four  in  the  afternoon.  Besides  these  rations,  the  patients 
receive,  at  eight  o'clock  in  the  morning,  if  prescribed  by 
the  physician,  some  soup,  coffee,  with  or  without  milk, 
a  milk  soup,  or  some  chocolate ;  but  this  distribution  is 
not  general ;  it  extends  only  to  those  of  the  sick  who 
appear  to  need  it. 

The  rigid  diet  includes  only  broths  and  jelly  broths. 
The  common  diet  is  composed  of  soups  in  the  following 
order  of  gradation  :  a  half  soup,  morning  and  evening, 
two,  three,  and  even  four  soups,  if  the  physicians  pre- 
scribe them,  or  rather  two  soups,  and  coffee,  alone  or 
with  milk,  a  milk  soup,  or  chocolate.  The  soups  of  the 

*  The  entire  ration,  after  being  ordered  three  days  in  succession,  is, 
in  exceptional  cases,  reduced  to  three-quarters,  when  they  then  return 
to  the  full  ration. 


212  APPENDIX. 

diet  are  made  at  the  option  of  the  physicians,  either 
with  farinaceous  ingredients,  like  vermicelli  and  semoulia, 
or  of  broken  bread. 

Besides  the  articles  above  enumerated,  they  have  a 
number  of  kinds  that  they  term  extra-ordinary,  which 
enter  into  the  daily  distribution,  and  will  be  mentioned 
when  we  come  to  notice  the  other  elements  of  their 
rations. 

The  common  quarter  ration  is  composed  of  two  or 
three  soups,  and  the  quantity  of  bread,  meat,  and  wine 
stated  in  the  table.  With  the  quarter  ration  they  may 
allow  the  patient  the  eight  o'clock  morning  meal,  with 
all  the  varieties  above  stated.  With  the  quarter  of  the 
ration,  the  boiled  meat  may  be  replaced  by  chicken, 
veal,  or  mutton,  or  by  vegetables,  such  as  potatoes, 
spinach,  carrots,  cabbages,  turnips,  &c.,  according  to 
tne  season.  They  may  also  add  two  poached  eggs,  and 
0.44  Ibs.  of  cooked  fruits  or  marmalade. 

The  two  gills  of  vin  ordinaire,  usually  added  to  the 
quarter  ration,  may  be  replaced  by  the  same  quantity  of 
some  generous  wine,  such  as  Bordeaux,  Malaga,  <fcc. 

The  half  ration  is  composed  of  two  soups,  to  which 
may  be  added  for  breakfast,  at  eight  o'clock,  another 
soup,  coffee  with  milk,  or  chocolate,  besides  the  quantity 
of  bread,  meat,  and  wine  given  in  the  table.  The  half 
ration  of  boiled  meat  may  be  also  replaced  by  a  half 
ration  of  ragout,  fowl,  gelatine,  veal,  or  roast  mutton, 
or  by  half  a  ration  of  vegetables ;  but  it  excludes  dried 
fruits  and  marmalade,  whose  distribution  here  forms  an 
exception,  and  is  only  allowed  in  certain  particular  cases. 
Wine  may  be  substituted  in  the  same  manner  as  in  the 
quarter  ration.  The  half  ration  of  meat  may  be  divided 
into  two  quarters,  as,  for  example,  a  quarter  of  ragout 
and  a  quarter  of  vegetables. 

The  three-quarter  ration  usually  remains  as  in  the 
table,  but  in  exceptional  cases,  a  soup,  coffee,  alone  or 
with  milk,  chocolate,  and  the  quantities  of  bread,  meat, 
and  wine,  given  in,  the  table,  may  be  added  as  breakfast. 
The  three-quarter  ration  of  boiled  meat  may  be  replaced 
only  by  a  three-quarter  ration  of  veal,  mutton,  ragout, 
vegetables,  or  salad,  fowl  and  gelatine  being  excluded. 


APPENDIX. 


213 


It  may  also  be  subdivided  into  a  half  ration  of  ragout, 
and  a  quarter  of  vegetables,  or  the  converse. 

The  entire  ration  consists  of  the  quantities  of  bread, 
meat,  and  wine,  mentioned  in  the  table.  In  the  Crimea, 
in  consequence  of  the  inferior  quality  of  the  meat,  and 
the  special  wants  of  the  sick,  it  was  permitted  to  add  an 
extra  ration  of  vegetables  to  that  given  in  the  table. 
Potato  and  fresh  lettuce  salads  were,  in  consequence, 
often  ordered  for  the  scorbutic  patients. 


III. 

Summary  of  immediate  "amputations  performed  in  the 
Crimea  /  received  and  treated  in  the  hospital  of  Gul- 
hane,  at  Constantinople  ;  and  of  delayed  operations 
performed  at  the  latter  place,  between  the  1st  of  May 
and  31st  of  December,  1855. 

IMMEDIATE  OPERATIONS  PERFORMED  IN  THE  CRIMEA. 

Died 
40 
13 
44 
23 
2 
9 
1 
3 


Kind  of  Operations.      Number.  Recovered. 

f  A  rm      .             ... 

91 

51 

AMPUTATIONS  IN 
THE  BONE, 

38 

74 
89 

25 
30 
66 

Thiffh. 

Leg,  place  of  preference, 

—  Submalleolar,      .     .    . 

4 

2 

'  Scapulo-lmmeral,    .     .     . 

25 

16 

Radio-carpal,     .... 

5 

4 

AMPUTATIONS  AT 

Carpo-metacarpal,  .     .     . 

9 

6 

THE  JOINTS, 

Femoro-tibial,  process  of 

M.  Baudens,  .... 

3 

3 

Tarso-metatarsal,    .    .     . 

7 

5 

„  (  Head  of  the  humerus,  pro- 

RESECTIONS,       .  -<      cess  of  M.  Baudens,    . 

3 

2 

(  Body  of  the  humerus, 

3 

1 

Total,        351 


211 


140 


CAUSES  o: 

Purulent  Infection,      ...     4  1 
Hospital  Gangrene,     ...     27 
Gangrene,      20 

B1    DEATH. 
Typhus.    . 

6 

Pleuritic  Effusion,  .     .     . 
"        Abdominal,  .     . 

Total, 

2 
.       2 

140 

Haemorrhage,     .... 
Chronic  Diarrhrea,      .     . 
Scurvy,     

.       2 
.     36 

4 

214 


APPENDIX. 


DELAYED    OPERATIONS    PERFORMED   IN   THE    HOSPITAL    OF 
GULHANJS. 

Kind  of  Operations.      Number.  Recovered.     Died. 


fArm,   .......    44 

AMPUTATIONS  IN)  Forearm,  ......    14 


LLeg,     

47 

AMPUTATIONS  AT 
THE  JOINTS, 

EESECTIONS,  . 
LIGATURE        OF 

Scapulo-humeral,   .     . 
Coxo-femoral,    . 
Femoro-tibial,    .     .     . 
Body  of  the  humerus, 
"        "      radius,     . 
"        "       femur,     . 
Primitive  carotid,  .     . 
Brachial   .... 

3 
2 
5 
1 
5 
1 
3 
g 

ARTERIES,  . 

11 

Anterior  tibial,  .     ?    . 

1 

Total,         177 


25 
9 


27 
2 


4 
4 
1 

87 


90 


CAUSES  OF  DEATH. 


Purulent  Infection,     ...  29 

Hospital  Gangrene,     ...  16 

Gangrene, 14 

Haemorrhage, 1 

Typhoid  Fever,       ....  5 


Scurvy,     ... 
Pleuritic  Effusion, 
Chronic  Diarrhoea, 


...       3 

...     22 

Total,,       90 


These  tables  show  at  once  the  great  advantages  in 
favor  of  amputations  performed  immediately  after  the 
wound,  over  those  in  which  a  considerable  length  of 
time  has  elapsed  ;  and  the  results  obtained  at  this  hos- 
pital are  similar  to  those  at  the  other  French  hospitals 
at  Constantinople.* 

*  The  experience  of  the  English  army  in  the  Crimea  fully  confirmed 
that  of  the  French,  in  favor  of  early  amputations  from  severe  injuries 
by  gunshot  wounds,  and  showed  that  every  hour  of  delay  lessened 
the  chance  of  a  favorable  issue.  Dr.  Macleod,  in  his  "  Notes  on  the 
Surgery  of  the  Crimean  War,"  has  collected  facts,  showing  that  1288 
cases  of  the  greater  amputations,  in  various  wars,  from  gunshot  wounds, 
were  followed  by  death  in  396  instances,  while  902  secondary  ampu- 
tations were  followed  by  death  in  586  cases.  The  per  centage  of 
30*7  in  the  former,  and  67-9  in  the  latter,  nearly  agrees  with  the  ex- 
perience of  the  Russians  in  the  Crimean  War.  They  lost  one-third  of 
the  primary,  and  two  thirds  of  the  secondary  amputations  of  this  class. 
— TR. 


APPENDIX.  215 

The  total  of  140  deaths  following  immediate  amputa- 
tions, and  90  deaths  to  87  recoveries  in  delayed  opera- 
tions, are  excessively  abnormal,  and  can  only  be  ex- 
plained by  the  striking  deterioration  of  the  health  of 
the  men  at  the  time  when  they  were  wounded,  and  by 
the  infection  which  prevailed  in  the  general  and  field 
hospitals.  When  I  had  charge  of  the  field  hospitals  of 
the  expeditionary  columns  in  Algeria,  it  often  happened 
with  me,  as  with  my  colleagues,  that  we  did  not  lose  a 
single  patient  from  amputation.  This  was  especially 
the  case  after  the  campaign  of  Mascara,  when  I  obtained 
fifteen  recoveries  in  succession.  In  one  of  the  later  ex- 
peditions in  Kabyiie,  M.  Bertherand,  chief  physician, 
met  with  results  equally  satisfactory  in  twenty  amputa- 
tions. A  comparison  of  amputations  with  resections, 
shows  also  that  the  advantage  rests,  as  I  have  often  ob- 
served, in  favor  of  the  latter,  thus  proving  that  the  do- 
main of  conservative  surgery  will"  be  constantly  enlarged. 
M.  Thomas,  the  skilful  surgeon  whose  practice  I  have 
above  stated,  coincides  with  my  views,  and  I  was  much 
pleased,  in  examining  his  patients,  to  find  the  successful 
results  obtained,  in  many  cases,  of  wounds  that  appear- 
ed to  demand  an  amputation  of  the  thigh,  through  the 
use  of  my  fracture  box.  Some  of  these  cases  will  be 
given  in  the  following  memoir.  : 


IV. 

Observations  upon  several  comminuted  fractures  of  the 
thigh  by  bullets,  resulting  in  cure  when  treated  with 
Mr.  IBaudens1  fracture  box,  reported  by  Mr.  Thomas, 
Physician-in-chief. 

BICHET,  a  sergeant  of  the  4th  marines,  of  good  consti- 
tution and  sanguine  temperament,  was  struck  on  the 
7th  of  June,  1855,  before  Sebastopol,  in  his  right  thigh 
by  a  ball  of  large  size.  On  his  arrival  at  the  hospital  of 
Gulhane  on  the  18th,  there  were  two  openings,  one  on 


216  APPENDIX. 

the  outside  and  the  other  on  the  inside  of  the  limb,  at 
its  lower  third.  The  bone  was  broken  with  many 
splinters,  and  two  of  these  1.18  inches  Jong,  and  of  the 
size  of  a  goose  quill,  with  many  of  less  size,  were  ex- 
tracted from  the  place  of  entry  of  the  ball,  somewhat 
enlarged  for  the  purpose.  This  reduced  the  case  to 
one  of  much  simplicity,  and  the  limb  was  placed  in  a 
box,  and  subjected  to  extension  and  counter  extension. 
In  ninety-two  days,  the  limb  was  consolidated  without 
deformity  or  shortening,  and  without  local  or  general 
accident.  This  subaltern  officer  rejoined  his  corps  early 
in  October. 

DEMAIN,  a  fusilier  of  the  86th  infantry,  a  young  soldier 
of  good  constitution,  was  wounded  June  9,  in  the  right 
thigh,  by  the  bursting  of  a  shell,  and  arrived  on  the  18th 
at  the  hospital  of  Gulhane.  He  had  a  long  wound  in 
the  upper  and  external  part  of  his  limb,  with  a  com- 
minuted fracture  of  the  femur,  about  three  quarters  of 
an  inch  below  the  great  trochanter.  Many  splinters 
were  extracted,  and  the  limb  was  placed  upon  cushions 
in  the  box,  from  whence  it  was  taken  three  months  after 
completely  set,  and  with  a  shortening  of  only  three 
quarters  of  an  inch.  The  recovery,  retarded  by  nume- 
rous abscesses,  occasioned  by  splinters  of  bone  and  pieces 
of  clothing  left  in  the  wound,  was  not  complete  before 
the  beginning  of  October,  when  he  was  sent  to  France. 

JUSEF-TESTANIEF,  a  Russian  prisoner,  received  on  the 
7th  of  June,  a  fracture  of  the  left  femur  below  the  great 
trochanter,  and  two  wounds  opposite  that  point,  on  the 
inner  and  upper  part  of  the  thigh,  indicated  the  path 
of  the  ball  which  committed  the  injury.  The  finger 
reached  a  considerable  number  of  large  fragments,  the 
removal  of  which,  on  the  20th  of  June,  resulted  in  a  loss 
of  substance  in  the  bone,  estimated  at  an  inch  and  a  half. 
The  limb  was  placed  in  a  box,  where  it  remains  at  the 
time  of  writing,  having  acquired  so  much  firmness,  that 
the  patient  can  move  it  perfectly.  The  first  wounds 
have  closed,  and  pus  flows  only  from  two  fistulous  open- 
ings caused  by  abscesses  from  little  splinters  of  bone, 
bits  of  clothing,  and  parts  of  the  ball,  of  which  the 
wound  was  never  entirely  freed.  He  was  still  in  our 


APPENDIX.  217 

wards,  when,  upon  signing  the  peace,  he  returned  to 
Russia,  perfectly  cured. 

SAMOCHENKO,  a  Russian  prisoner,  received,  June  7, 
a  ball  which  passed  from  without  inward,  through  the 
middle  part  of  his  left  thigh,  causing  a  comminuted 
fracture  of  the  femur  at  that  point.  On  the  19th, 
he  was  admitted  into  our  hospital,  where,  after  the 
extraction  of  four  large  fragments  of  bone  and  many 
pieces  of  clothing,  his  limb  was  placed  in  a  box,  and 
kept  till  October  20.  The  consolidation  was  then  com- 
plete, but  there  existed  a  shortening  of  one  and  a  half 
inches.  Notwithstanding  the  restlessness  of  the  patient, 
his  cure  was  not  delayed  by  any  accident,  either  local 
or  general.  He  is  waiting  in  our  wards,  to  be  sent  to 
Odessa. 

ZEKEPA  (Simon),  a  Russian  prisoner,  on  the  7th  of 
June,  was  struck  by  a  cylindro-conical  ball,  which  passed 
through  the  right  thigh,  from  front  to  rear,  on  the  level 
of  the  great  trochanter,  fracturing  the  femur  into 
splinters.  On  the  19th,  when  admitted  at  Gulhane,  we 
extracted  many  splinters,  and  applied  the  fracture  box. 
After  a  treatment  of  four  and  a  half  months,  frequently 
embarrassed  by  abscesses  of  intermittent  recurrence, 
and  relapses  of  diarrhoea,  this  patient  was  sent  to  Odessa 
with  a  limb  entirely  solid,  and  shortened  only  three- 
fourths  of  an  inch. 

FERNET  (Felix),  sergeant-major  in  the  85th  infantry, 
received  September  8th,  a  baD,  which  entered  the  ex- 
terior and  upper  part  of  the  right  thigh,  and  fractured 
the  middle  of  the  femur.  A  few  hours  after,  a  field 
hospital  surgeon  extracted  many  splinters,  and  applied 
Scultet's  bandage.  On  taking  off  this  apparatus  for  the 
fourth  time,  on  the  27th,  upon  entering  the  hospital  at 
Gulhane,  the  limb  was  badly  swollen,  painful,  and  covered 
with  a  thick  layer  of  bloody  and  putrid  pus.  It  was  at 
once  placed  in  a  fracture  box,  and  covered  with  an 
emollient  and  narcotic  decoction.  On  the  2d  of  October, 
the  swelling  having  quite  disappeared,  we  found  that 
the  ball  had  only  made  one  opening,  and  that  a  cylin- 
drical piece  of  bone  four  or  five  inches  long,  formed  by 
the  whole  size  of  the  femur,  was  detached  and  crowded 


218  APPENDIX. 

towards  the  inner  part  of  the  thigh.  The  finger  passed 
into  the  wound  detected  no  other  foreign  substance. 
This  condition  being  known  and  examined,  we  brought 
the  fragments  into  position,  and  kept  them  in  place  by 
extension  and  counter  extension,  by  the  aid  of  adhesive 
straps,  fastened  upon  different  parts  of  the  limb.  Up  to 
the  21st  of  October,  several  abscesses  had  opened,  and 
the  last  one  gave  exit  to  the  ball.  Since  the  escape  of 
this  substance  every  day  has  witnessed  an  improvement 
in  the  condition  of  the  limb,  and  the  general  health  of 
the  patient;  and  now  (Jan.  4,  1856),  the  consolidation 
of  fragments  is  far  advanced,  the  limb  preserves  its  form 
and  proper  length,  the  suppuration  is  slight  and  of  good 
quality ;  the  health  of  the  patient  is  excellent,  so  that 
we  may  look  forward  to  an  early  and  complete  recovery. 
Two  months  after  Fernet  returned  to  France  perfectly 
cured. 

These  cases,  I  doubt  not,  will  be  studied  with  a  lively 
interest  by  surgeons  worthy  of  the  name.  They  prove, 
contrary  to  received  opinion,  that  comminuted  fractures 
of  the  femur  with  wounds  are  not  necessarily  subjects 
for  amputation,  if  we  take  care  to  extract  the  splinters 
and  foreign  bodies,  so  as  to  render  a  complicated  wound 
simple,  and  then,  by  the  aid  of  a  proper  apparatus,  place 
the  limb  in  a  state  of  complete  rest  without  shaking  it, 
even  during  the  dressings,  and  giving  to  the  purulent 
fluids  an  easy  outlet.  I  might  have  borrowed  similar 
facts,  from  other  surgeons  in  our  hospitals  at  Constan- 
tinople, and  thus  increase  the  number,  but  they  would 
have  afforded  nothing  further  of  special  interest.  I 
cannot  meanwhile  pass  in  silence  the  observations 
recorded  in  the  following  chapter,  and  which  attest  the 
wonderful  power  of  surgical  art  in  skillful  hands. 


V. 

Fractures  of  the  femur,  caused  by  projectiles.  Cases 
of  distorted  bony  union  in  broken  thighs,  remedied  at 
long  periods  after  the  accident,  by  the  use  of  thefrac- 


APPENDIX.  219 

ture  apparatus  of  M.  Baudens.  Report  of  M.  Mau- 
pin,  Chief  Physician  of  the  hospital  at  the  Parade- 
grounds  at  Constantinople. 

AMAK,  a  fusilier  of  the  21st  regiment  of  the  line,  was 
shot  in  the  left  thigh,  September  20,  1855.  The  ball, 
which  was  of  large  size,  entered  on  the  front  exterior 
part,  at  the  upper  third  of  the  limb,  and  lodged  under 
the  integuments,  having  passed  through  the  great  tro- 
chanter.  The  femur  received  a  comminuted  fracture,  and 
considerable  haemorrhage  occurred.  The  patient  would 
not  submit  to  the  disarticulation  of  the  limb  at  the  hip. 
The  wound  was  enlarged,  the  splinters  of  bone  removed, 
and  simple  dressings  applied  twenty  days.  The  limb, 
placed  in  a  half  bent  position,  rested  upon  a  blanket, 
rolled  up,  so  as  to  form  a  hollow  trough.  Some  strips 
of  bandage  completed  this  rude  apparatus,  for  which,  in 
eight  days,  that  of  Scultet  was  substituted,  and  the 
patient  was  sent  from  the  Crimea  to  Constantinople. 
Upon  arriving  at  our  hospital  (October  14th),  the  wound 
was  tainted  with  spots  of  hospital  gangrene.  The  thigh, 
shortened  at  least  five  fingers'  breadth,  formed  from 
without  inward  the  arc  of  a  circle,  the  heel  touching  the 
right  calf,  when  the  patient  allowed  his  two  thighs  to 
take  their  own  position.  Amaris  a  man  full  of  courage, 
and  has  faith  that  he  will  recover  without  an  amputa- 
tion. The  limb  was  placed  in  an  inclined  plane,  the  foot 
being  fastened  to  the  foot  of  the  bed.  A  cloth  folded 
in  many  thicknesses,  and  placed  between  his  thighs, 
effected  counter-extension,  but  at  the  end  of  thirty  days, 
no  change  in  the  deformity  or  shortening  of  the  limb 
being  apparent,  the  apparatus  of  M.  Baudens  was  ap- 
plied. On  the  15th  of  March,  when  Amar  was  sent  to 
France,  the  wounds,  whose  dressings  were  easily  applied 
by  aid  of  this  apparatus,  had  been  cicatrized  for  some 
time,  the  limb  was  slowly  coming  back,  without  torture, 
or  even  appreciable  pain,  and  in  an  almost  perfect  man- 
ner, to  its  normal  position,  and  the  shortening  was  re- 
duced, at  the  most,  to  three-fourths  of  an  inch.  The  place 
of  consolidation,  very  voluminous  at  first,  was  notably 
diminished,  and  its  irregularities  were  lost  in  the  gene- 


220  APPENDIX. 

ral  ossification.  The  thigh,  which  was  much  shrunk  in 
November,  had  increased  in  volume,  and  its  movements 
were  in  every  way  easy  and  free. 

ALBARIC  (JOHN),  fusilier,  of  the  80th  regiment  of  the 
line,  September  8,  1855,  received  a  musket  shot  on  the 
outer  side  of  the  right  thigh,  at  the  point  of  junction  of 
the  upper  external  and  middle  third.  There  was  but 
one  opening.  An  examination  at  the  field  hospital  of  the 
second  division,  found  fracture  of  the  thigh,  extracted 
several  fragments  of  bone  and  the  projectile,  and  applied 
a  simple  apparatus,  consisting  of  compresses,  bandages, 
and  four  splints. 

On  the  19th  of  October,  Albaric  was  sent  from  the 
Crimea  to  the  hospital  at  the  parade-ground.  The  bony 
union  had  already  become  so  firm,  that  it  allowed  of  the 
limb  being  raised,  but  the  natural  curve  of  the  thigh  was 
much  increased,  and,  moreover,  at  the  place  where  the 
entry  of  the  projectile  was  hidden  by  the  cicatrix,  there 
was  a  lump  caused  by  the  angle  at  meeting  of  the  two 
pieces  of  the  femur,  and  the  limb  was  shortened  full  four 
fingers'-breadth.  While  the  leg  was  slightly  bent  upon  the 
thigh,  the  foot  was  very  much  twned  outward.  The  limb 
was  subjected  to  a  very  simple  kind  of  continued  exten- 
sion, by  being  stretched  between  the  head  and  foot  of  an 
iron  bedstead,  that  is  to  say,  it  was  mal-treated.  The 
hospital  gangrene  devoured  the  cicatrix,  and  spread 
deep  and  wide. 

On  the  2d  of  January,  1856,  the  shortening  and  de- 
formity of  the  limb  were  very  nearly  as  they  were  on 
the  19th  of  October,  and  yet  the  solid  appearance  of  the 
bony  soldering  had  not  suffered  from  the  proximity  to 
the  hospital  gangrene.  The  limb  was  placed  in  the  per- 
manent extension  apparatus  of  M.  Baudens,  by  the  aid 
of  which  dressings  maybe  daily  applied  to  the  gangrene 
with  great- facility.  By  the  15th  of  March,  the  limb  had 
been  gradually  brought  back  in  length,  direction,  and 
form,  to  correspond  very  nearly  with  the  other,  and  the 
patient  could  move  it  as  easily.  Still  the  hospital  gan- 
grene, although  carefully  treated,  remained.  Twenty 
times  it  came  to  some  kind  of  healing,  and  it  would  then 
relapse,  showing,  by  its  oscillations,  the  effects  of  the 


APPENDIX.  221 

sick  man's  surroundings.  At  the  place  of  the  fracture, 
the  thigh  is  now  but  slightly  swollen. 

SALARD,  a  grenadier,  of  the  18th  regiment  of  the  line, 
August  13th,  1855,  met  with  a  violent  contusion  of  the 
right  thigh  by  a  musket  ball,  at  a  point  three  fingers' - 
breadth  above  the  knee-pan ;  the  integuments  were  only 
excoriated,  but  the  femur  was  fractured,  and  an  ecchy- 
mosis  continued  for  several  days.  It  will  be  proper  to 
note  that,  four  days  before  his  wound,  Salard  left  the 
infirmary  of  his  corps,  where  he  had  been  under  treat- 
ment for  arthritic  rheumatism  of  the  right  knee,  which 
had  left  a  soreness  and  pain  upon  moving  the  joint.  At 
the  field  hospital  in  the  Crimea,  the  limb  had  been  en- 
veloped in  three  splints,  resting  upon  three  small  cush- 
ions. In  this  condition,  the  patient  arrived,  on  the  20th 
of  August,  at  the  hospital  of  the  Parade  ground.  There 
was  much  swelling  of  the  thigh  and  knee,  which  were 
extensively  ecchymosed.  The  femur  was  fractured  at 
its  lower  extremity,  but  the  swelling  did  not  allow  of 
any  examination  into  the  condition  of  the  bone.  The 
limb  was  placed  in  a  half  flexed  position,  kept  so  by 
pieces  of  linen  folded  around  it,  and  enveloped  in  com- 
presses kept  constantly  wet  with  bran  and  water.  The 
swelling  being  reduced,  a  fracture  of  the  femur,  just 
above  the  condyles,  was  found.  The  lower  fragment 
was  considerably  raised,  and  the  upper  one  made  a  lump 
very  appreciable  to  the  touch  in  the  bend  of  the  knee. 
The  member  was  at  once  placed  in  the  modified  appara- 
tus of  the  Hotel-Dieu,  and  retained  nearly  two  months 
in  it,  with  but  little  pain  at  first,  but  a  great  deal  of  in- 
convenience towards  the  end.  From  time  to  time  the 
extension  was  increased,  as  much  as  an  apparatus  of  this 
kind  would  allow  of.  The  apparatus  was  removed  in 
the  early  part  of  November.  The  bony  union  was  then 
so  far  advanced,  that  the  patient  could  raise  the  member 
at  will,  but  the  joining. was  very  voluminous,  and  the 
limb  was  noticeably  shortened.  The  knee  was,  besides, 
considerably  swollen,  and  presented  evidence  of  incipient 
hydrarthrosis. 

Being  impatient  of  further  restraint,  the  patient 
rejected  every  measure  proposed  in  view  of  relieving 


222  APPENDIX. 

the  difficulty,  and  attempted  to  walk.  The  swelling  of 
the  knee  enlarged,  it  became  painful,  and  the  effusion 
increased.  Salard  was  compelled  to  take  to  his  bed 
again;  but  his  constitution,  which  had  hitherto  been 
quite  vigorous,  became  impaired  in  a  very  marked 
degree,  and  symptoms  of  a  scorbutic  character  ap- 
peared. It  became  difficult,  and  then  impossible,  to 
raise  the  thigh  without  assistance,  and  it  appeared  pro- 
bable that  the  bony  union  was  disposed  to  yield  to 
methodical  and  continued  traction.  The  limb  was 
placed  in  the  apparatus  of  M.  Baudens,  where  it 
remained  about  three  months.  By  varied  means,  and 
especially  by  the  aid  of  vesicatories  repeatedly  applied, 
the  swelling  of  the  knee  was  reduced  to  the  proportions 
inseparable  from  a  grave  fracture.  The  shortening  of 
the  limb,  which  was  more  than  three  fingers'  breadth, 
when  taken  from  the  Hotel  Dieu  apparatus,  had  been 
extended  to  about  a  third  of  an  inch  of  its  proper 
length.  The  general  projection  of  the  soldered  part 
was  still  perceptible  in  the  bend  of  the  knee,  but  deeper 
and  better  hi  the  axis  of  the  femur.  Walking,  though 
still  difficult,  was  no  longer  painful.  It  grew  stronger 
every  day,  and  the  knee,  instead  of  swelling,  became 
reduced  to  its  proper  volume.  He  left  the  hospital  on 
the  15th  of  March,  happy  at  having  escaped  by  his 
second  recovery,  as  far  as  was  possible,  the  incon- 
veniences that  would  have  followed  the  first. 

MEUNIER,  a  fusilier  of  the  21st  of  the  line,  September 
8,  1855,  was  shot  by  a  musket  in  the  left  thigh,  the  ball 
striking  the  superior  external  part  of  the  limb,  a  little 
below  the  great  trochanter,  fracturing  the  femur  at  that 
point  into  splinters.  There  was  no  opening  of  exit,  and 
no  resulting  circumstances  occurred  to  indicate  whether 
the  projectile  was  buried  in  the  limb  or  not.  Eight 
hours  after  the  accident,  the  patient  was  removed  to 
the  field  hospital  of  the  Second  Division.  The  limb  was 
then  considerably  swollen.  Simple  dressings  were  ap- 
plied. The  shortening  amounted  to  nearly  two  inches. 
On  the  20th  of  September,  the  apparatus  of  Scultet  was 
applied.  The  wound,  freed  from  splinters,  tended 


APPENDIX.  223 

rapidly  towards  cicatrization.  Although  hospital  gan- 
grene prevailed,  he  was  not  attacked  with  that  disease. 
At  the  Hospital  of  the  Parade  Ground,  where  Meunier 
arrived  on  the  30th  of  September,  the  apparatus  of 
Scultet  was  renewed,  and  the  cicatrization  of  the  wound 
was  completed  under  this  treatment.  On  the  28th  of 
November,  when  the  patient  passed  from  the  fourth  to 
the  first  division  of  the  wounded,  the  soldering  of  the 
bone  was  complete,  although  very  voluminous  and  irre- 
gular, and  had  so  far  progressed,  that  he  could  move  his 
thigh  without  appreciable  pain.  The  shortening  of  the 
limb  was  three  full  fingers'  breadth.  The  apparatus  box 
of  M.  Baudens  was  adapted  to  the  limb,  and  extension 
applied,  both  to  the  thigh  and  lower  leg,  and  maintained 
till  the  end  of  February.  On  the  10th  of  March,  the 
patient  was  sent  to  France.  There  was  then  scarcely 
any  shortening  perceptible  upon  measurement,  and  the 
bony  knob  at  the  point  of  union  had  well  nigh  dis- 
appeared. 

This  case  proves  anew,  that  when  there  is  a  faulty 
consolidation  of  recent  occurrence,  we  may,  notwith- 
standing the  defective  relation  of  the  bony  parts  to  one 
another,  so  far  correct  the  misfortune,  that  in  the  least 
successful  cases  there  will  remain  but  a  simple  shorten- 
ing compatible  with  the  free  use  of  the  limb. 

Up  to  what  period  may  a  faulty  soldering  of  the  bone 
be  remedied  ?  I  am  not,  at  present,  able  to  show  pre- 
cisely, although  my  experience  embraces  nine  successful 
cases.  Still,  I  certainly  would  not  accept  the  narrow 
limits  which  dogmatic  teaching  has  prescribed  in  the 
application  of  trial  methods ;  and  I  would  observe,  that 
several  of  my  cases  have  been  taken  in  hand  within  four 
months  of  the  lesion,  when  the  soldering  presented  such 
solidity  that  the  patient  could  raise  the  limb.  In  these 
same  cases,  the  most  faulty  union  of  bone  yielded  very 
readily  to  continued  and  graduated  extension,  and,  two 
months  later,  had  taken  a  proper  direction,  and  showed 
an  elongation  that  I  had  scarcely  hoped  to  effect. 

Of  all  the  means  or  apparatus  which  I  have  used  to 
correct,  as  much  as  possible,  the  deformities  of  the  sol- 
dering, there  has  been  none  more  convenient  in  applica- 


224  APPENDIX. 

tion,  or  more  sure  of  success,  than  that  which  I  used  in 
the  cases  here  described.  It  combines  all  the  modifica- 
tions of  traction  and  extension  deemed  necessary,  and, 
at  the  same  time,  is  as  inflexible  as  we  could  desire  in  an 
apparatus  of  this  kind.  This  action  may  be  gradually 
increased  without  appreciable  pain  to  the  patient,  con- 
ditionally, and  here  lies  the  whole  secret  of  the  success 
of  all  apparatus,  that  the  different  parts  be  carefully 
fitted,  and  the  effects  closely  watched.  As  it  does  not 
cover  up  the  limb,  the  proper  dressings  can  be  applied 
to  the  wound,  without  in  any  way  interfering  with  its 
efficacy. 


VI. 

Observations    collected   by  M.   Beaufils,  Aide-Major 
Physician. 

I. — SPONTANEOUS  LOSS  OF  BOTH  FEET  FROM  CONGELA- 
TION.— CUBE. 

MANGIN,  aged  twenty-three,  of  feeble  constitution  and 
nervous  temperament,  belonging  to  the  62d  regiment  of 
the  line,  after  five  months'  residence  in  the  Crimea,  had 
both  feet  frozen,  while  sleeping  in  his  tent,  on  the  night 
of  March  19.  He  was  sent  to  the  hospital  at  Gulhane, 
where  he  arrived  April  11,  1856.  Both  feet  were  cold 
and  insensible,  and  the  tissues  had  a  black  and  lifeless 
aspect,  with  a  line  of  separation  around  them  at  the 
ankles.  The  patient  appeared  weak  and  broken  down. 
There  was  no  fever.  By  the  30th  of  April,  the  circle  of 
elimination  had  made  progress,  the  tissues  were  deeply 
ulcerated,  the  tendons  exposed,  and  fleshy  granulations 
appeared  along  the  edge  of  the  wound  towards  the  leg. 

By  the  5th  of  May,  the  bones  of  the  legs  were  entire- 
ly denuded  as  far  as  the  ankles,  the  left  foot  was  only 
held  by  some  tendons,  and  by  the  ligaments  of  the  joint, 
which  were  completely  dissected.  A  few  clips  of  the 
scissors  detached  the  foot  from  the  leg,  without  a  drop 
of  blood  following,  and  without  its  loss  being  felt  by  the 


APPENDIX.  225 

patient.  On  the  next  day,  May  6th,  the  same  operation 
was  performed  upon  the  right  foot.  The  patient  was 
much  pleased  at  being  relieved  from  the  annoying  weight 
at  the  extremities,  which  had  prevented  him  from  turn- 
ing in  bed.  On  the  8th  of  May,  he  was  placed  under 
the  influence  of  chloroform,  and  the  operation  of  resec- 
tion of  the  ankles  was  performed,  as  indicated  by  M. 
Baudens  in  his  method  of  tibio-tarsal  amputation.  The 
borders  of  the  wound  were  soon  covered  with  fleshy 
granulations  that  completely  enveloped  the  extremity  of 
the  bone,  and  now,  May  30th,  the  wounds  are  almost 
entirely  closed,  the  cicatrices  are  regular,  and  the  patient, 
being  considered  as  cured,  is  about  to  return  to  France. 

II. — PARTIAL  AMPUTATION  OF  BOTH  FEET,  IN  CONSE- 
QUENCE OF  FREEZING,  ONE  COMPLETED  SPONTANEOUSLY, 
AND  THE  OTHER  BY  SURGICAL  AID. 

MANAVELLA,  of  Piedmontese  origin,  a  soldier  of  the 
second  foreign  legion,  aged  twenty  years,  of  good  consti- 
tution and  nervous  temperament,  after  fourteen  months' 
residence  in  the  Crimea,  entered  the  field  hospital  of  the 
fourth  division  on  the  1st  day  of  January,  1856,  attack- 
ed by  typhus.  Being  placed  under  a  tent  both  his  feet 
were  frozen.  Upon  recovering  from  the  typhus,  he  was 
sent  to  the  hospital  at  Gulhane,  where  he  arrived  on  the 
14th  of  February. 

The  extremities  of  both  feet,  and  as  far  up  as  the  tar- 
so-metatarsal  articulation,  were  completely  mummified ; 
black,  hard,  resonant  like  a  piece  of  wood,  insensible, 
dry,  and  horny.  The  toes,  being  dried  together,  could 
not  be  moved.  The  general  health  was  satisfactory, 
and  the  patient  ate  with  relish  the  quarter,  and  after 
some  days  the  half  ration.  The  pain,  which  had  been 
but  slight,  on  the  20th  of  March  became  more  acute. 
A  circle  of  elimination  was  formed  upon  the  right  foot, 
and  the  affected  part  soon  ulcerated.  The  suppuration 
became  abundant,  the  pain  very  acute,  and  the  slightest 
dressings  could  not  be  applied  without  exciting  cries  of 
distress.  The  extremity  of  the  foot  drew  heavily  upon 
the  ligaments,  causing  great  torture  to  the  patient,  who, 
nevertheless,  could  not  bring  himself  to  consent  to  an 

11 


226  APPENDIX. 

operation.  On  the  5th  of  April  the  medio-tarsal  articu- 
lation opened,  the  ligaments  were  in  part  destroyed, 
and  the  skin  held  only  to  the  bottom  of  the  foot.  A  few 
clips  of  the  scissors  completed  the  amputation  that  had 
been  begun  and  partly  finished  by  nature.  The  scaphoid 
bone  remained  in  place  ;  the  three  cuneiform  bones  and 
the  cuboid  bone  were  removed,  and  but  little  blood  fol- 
lowed the  operation.  The  borders  of  the  wound  were 
covered  with  bright  florid  granulations,  of  healthy  cha- 
racter. 

On  the  20th  of  April,  the  flesh  covered  the  scaphoid 
bone.  The  granulations  were  of  a  vermillion  red  color, 
the  wound  was  diminished  in  extent,  the  suppuration 
was  of  good  quality  and  less  abundant,  and  the  pain  had 
ceased.  On  the  30th  of  April  the  wound  presented  a 
very  good  appearance,  and  was  much  reduced,  and  now, 
May  30th,  it  has  entirely  closed. 

The  left  foot  took  much  longer  time  to  eliminate  itself 
than  the  right.  Although  the  toes  and  lower  parts  of  the 
foot  were  equally  mummified,  black,  shrivelled,  hard  as 
wood,  glued  together,  and  completely  insensible,  yet  the 
circle  of  separation  had  not  begun  to  appear  by  the  20th 
of  April.  Thinking  that,  the  gangrene  being  only  super- 
ficial, vitality  might  be  restored  to  the  toes,  the  foot  was 
subjected  to  a  continued  irrigation  of  cold  water.  On 
the  20th  ^of  April,  the  skin  of  the  great  toe  appeared 
macerated  and  white  in  places.  On  the  24th,  the  extre- 
mity of  the  foot  had  passed  from  black  to  white.  The 
heel  and  lower  part  of  the  leg  were  warm.  The  patient 
feels  well ;  there  is  no  pain  or  chills ;  the  irrigation  of 
the  limb  was  continued.  On  the  26th  a  line  of  elimina- 
tion appeared  at  the  level  of  the  tarso-metatarsal  articu- 
lation ;  the  tissues  over  the  tarsal  bones,  which  were 
slightly  swollen,  became  white,  and  almost  insensible  to 
pressure.  The  toes  were  still  mummified,  hard,  and  cover- 
ed with  a  thick  layer  of  white  epidermis,  that  could  be 
removed  like  a  blister  by  the  aid  of  a  spatula.  On  the 
27th,  the  tissues  appeared  to  take  new  life,  and  the  great 
toe,  particularly,  showed  a  slight  tinge  of  redness.  The 
patient  felt  a  little  life  in  it.  On  the  30th,  the  foot  present- 
ed the  same  favorable  aspect,  and  the  irrigation  was  con- 


APPENDIX.  227 

stantly  continued.  On  the  2d  of  May,  the  mummification 
of  the  tissues  had  almost  entirely  disappeared,  the  toes 
showed  a  fleshy  color,  especially  the  great  toe  and  the 
third.  They  were  less  stiff,  less  glued  together,  and 
there  was  neither  pain  nor  offensive  odor.  On  the  3d  of 
May  the  patient  could  stir  the  toes,  and  effect  some 
slight  movements.  On  the  4th  of  May,  a  line  of  demar- 
cation appeared  on  the  back  of  the  foot,  without  inflam- 
mation, pain,  or  redness,  and  worms  were  continually 
multiplying  in  the  wound.  On  the  6th  of  May  it  was 
deeper,  and  continued  to  extend,  the  patient,  meanwhile, 
showing  no  signs  of  suffering  or  of  reaction.  The  irri- 
gation, which  was  continued,  prevented  pain  and  sup- 
pressed all  bad  odors.  At  length,  on  the  13th  of  May, 
the  alteration  having  continued  to  extend  in  depth,  a 
considerable  change  in  the  osseous  tissue  could  be  de- 
tected. Mr.  Thomas,  Chief  Physician,  performed  a 
medio-tarsal  amputation,  preserving  as  much  as  possible 
of  the  soft  parts.  A  haemorrhage  occurred,  which  was 
arrested  by  the  perchloride  of  iron.  The  patient,  at  the 
time  of  operation,  was  under  the  influence  of  chloroform. 
At  this  time,  May  30th,  the  wound  has  completely 
closed,  and  the  patient  may  be  considered  cured. 

These  two  cases  show  very  conclusively  the  appear- 
ance and  progress  of  injuries  caused  by  frost-bite.  They 
indicate  the  prudent  course  to  be  followed-  by  the  sur- 
geon, whose  only  object  should  be  to  second  the  efforts 
of  nature,  and  to  come  to  her  aid  only  when  she  cannot 
effect  her  object  alone.  The  aid  of  the  surgeon  should 
be  particularly  withheld  when  the  constitution  of  the 
patient  is  broken  down,  or  when  he  is  infected  with 
miasmatic  poison.  We  have,  in  the  foregoing  pages, 
shown  that  operations,  apparently  the  most  innocent, 
were  sufficient  at  times  to  excite  hospital  gangrene  in 
the  hospitals  of  the  Crimea  and  at  Constantinople.  It 
was  not  till  later,  when  the  hospitals  had  been  purified 
from  this  terrible  scourge,  that  surgical  operations  were 
relieved  from  the  saddening  occurrence  of  reverses,  and 
that  amputations  could  be  performed  with  fair  chances 
of  success. 


228  APPENDIX. 


Report  of  Mr.  Thomas,  Physician-in-cJdef,  upon  the 
Sanitary  Condition  of  Constantinople,  during  the 
month  of  January,  1856,  addressed  to  the  Medical 
Inspector  of  the  Army  of  the  East. 

"  From  the  1st  to  the  31st  of  January,  inclusive,  13,520 
patients  were  treated  in  our  hospitals,  of  whom  895 
were  wounded  by  the  fire  of  the  enemy ;  504  by  other 
causes;  1,075  were  frost-bitten,  and  11,048  were  fever 
patients  received  from  the  Crimea,  from  troops  in 
passage,  and  from  the  garrisons.  Since  the  first  of 
January,  the  arrivals  of  troops  sent  for  medical  treat- 
ment from  the  Crimea,  have  been  more  frequent  and 
numerous  than  in  the  preceding  months,  and  the  increas- 
ing numbers  of  sick  under  care,  have  rapidly  consumed 
the  means  provided  by  the  administration,  who,  count- 
ing upon  the  continuance  of  the  sanitary  condition  of 
November,  had  discontinued  the  hospitals  at  the  Pre- 
paratory School,  at  Maslak,  No,  1,  and  reduced  by  a 
third,  the  number  of  beds  in  the  other  establishments.* 

"  Excepting  some  cases  of  old  wounds,  kept  in  the 
hospitals  since  the  taking  of  Sebastopol,  and  a  few 
hundred  men  frost-bitten,  we  find  that  those  sent  to  the 
hospitals  during  the  month,  consisted  entirely  of  febrile 
patients  tainted  with  scurvy,  diarrhoea  or  chronic 
dysentery,  and  typhus.  Scurvy  is,  so  to  speak,  the 
exclusive  disease  of  the  febrile  patients  arriving  from 
the  Crimea  during  the  month,  and  exists  with  them  all, 
either  alone  or  complicated  with  other  affections.  Many 
of  them  present  symptoms  of  advanced  cachexy,  great 
anemia,  general  swelling,  fungous  ulceration  of  the 
gums,  sanguineous  and  painful  infiltrations  of  the 
limbs,  serous  effusions  in  the  cellular  tissues,  peritonitis, 
pleuritis,  pulmonary  oedema,  diarrhea  almost  always 
accompanied  by  hemorrhages,  etc. 

"  Cases  of  diarrhoea  and  chronic  dysentery  are  very 
common,  stubborn,  and  destructive.  I  have  already,  in 
several  of  my  preceding  reports,  had  the  honor  of  stat- 

*  This  latter  measure  had  been  adopted  at  my  request,  in  view  of 
disencumbering  and  purifying  the  hospitals. 


APPENDIX.  229 

ing  to  yon,  facts  concerning  a  special  complication 
which  has  for  some  months  changed  completely  the 
appearance  of  our  wards.  It  prevailed  in  our  hospitals 
during  the  winter  of  1855,  and  has  been  commonly 
denominated  the  typhic  condition.  During  the  present 
year,  it  has  also  prevailed,  at  the  same  epoch,  and 
attended  with  almost  identical  symptoms.  HoAvever, 
our  physicians  are  far  from  agreeing  as  to  its  nature, 
and  while  some  regard  it  as  a  variety  of  typhoid  fever, 
others  consider  it  a  severe  form  of  remittent  fever ;  the 
majority  regard  it  as  the  typhus  of  camps,  hospitals,  etc. 

"  This  typhus  threatens  to  assume  the  dimensions  of  a 
great  epidemic,  and  is  observed  chiefly  among  the  sick 
arriving  from  the  Crimea,  where  our  soldiers  live  under 
conditions  most  favorable  for  its  development.  They 
are  there  deprived  of  hygienic  attentions,  are  over- 
crowded and  exposed  to  the  deleterious  emanations  of 
a  soil  profusely  charged  with  organic  matter  of  every 
kind,  and  impregnated  with  the  effluvia  of  more  than 
twenty  thousand  decaying  men  and  animals.  The  resi- 
dence in  our  wards  of  a  certain  number  of  men  infected 
with  this  pernicious  disease,  has  developed  a  true  epi- 
demic typhus,  whose  malign  influence  is  reflected  upon 
those  sick  of  other  and  chronic  diseases,  and  upon  the 
attendants,  sisters  of  charity,  and  physicians  upon 
duty. 

"This  disease,  notwithstanding  its  many  points  of 
resemblance  to  typhoid  fever,  appears  to  me  to  differ 
from  it  essentially,  in  the  manner  of  its  attack,  the  pro- 
gress of  its  symptoms,  the  duration  of  the  various  atten- 
dant conditions,  and  the  pathological  changes  that  result 
from  its  action.  Thus,  contrary  to  what  takes  place 
among  the  greater  number  of  cases  of  typhoid  fever, 
we  rarely  have  a  premonitory  period ;  and  the  greater 
number  of  cases  of  typhus  which  we  have  observed, 
attacked  convalescents  from  other  diseases,  or  persons 
in  health. 

"  We  have  seen  it  almost  always  appear  suddenly,  with 
an  initial  chill,  followed  by  a  burning  fever,  and  severe 
pain  in  the  forehead,  which  was  soon  followed  by  a 
furious  or  tranquil  delirium,  according  to  the  degree  of 


230  APPENDIX. 

nervous  susceptibility,  or  perhaps  the  paludal  intoxica- 
tion of  the  patient.  These  first  symptoms  were  followed 
closely  by  stupor  and  general  prostration,  and  often 
this  lethargy  showed  itself  the  first  day  in  debilitated 
patients.  These  showed  an  extreme  depression  of 
vitality  in  the  expression  of  the  countenance,  and  an 
indescribably  death-like  cast  of  features,  which  constitute 
one  of  the  pathological  symptoms  of  typhus.  Loss  of 
hearing  existed  in  a  great  majority  of  cases. 

"  During  the  whole  course  of  the  fever,  the  skin  re- 
mained dry  and  burning.  It  was  often  covered  with 
petechial  spots,  but  rarely  among  the  sick  whose  con- 
stitutions, impaired  by  previous  diseases,  had  not 
strength  to  bring  on  reaction,  and  suscitate  the  stage 
of  elimination.  This  eruption,  either  separate  or  con- 
fluent, and  red,  purple,  or  brown,  appearing  from  the 
first  to  the  third  day,  differed  from  the  lenticular  rosy 
spots  of  typhoid  fever  in  their  form,  which  resembled 
the  eruption  of  measles,  by  their  early  appearance  and 
by  their  duration,  which  was  rarely  more  than  four 
days. 

"  The  thirst  of  the  patients  was  proportioned  to  the 
intensity  of  the  fever.  Frequently  the  tongue  remained 
clean  and  moist,  and  only  in  very  prolonged  and  severe 
cases,  or  with  those  having  a  scorbutic  taint,  was  it 
covered  with  a  yellow  or  brown  coat.  We  have  at 
times  seen  it  of  a  blood-red  color,  attended  with  ex- 
treme dryness,  and  a  remarkable  uncertainty  in  its 
motions. 

"The  bowels  usually  preserved  their  pliability  and  nor- 
mal susceptibility;  and  if  they  were  the  seat  of  pain,  it 
was  transient,  light,  and  spread  over  the  whole  surface 
of  the  abdomen,  or  fixed  under  the  sub-umbilical  region. 
It  was  rarely  felt  exclusively  in  the  right  iliac  fossa,  and 
crepitation  existed  in  this  region  only  in  patients  suffer- 
ing from  diarrhoea.  Constipation  is  the  more  common 
condition  with  typhic  patients,  while  meteorism,  so  com- 
mon in  typhoid  fever,  was  very  rarely  observed. 

"  The  lungs  of  scorbutic  patients  tainted  with  typhus 
often  became  the  seat  of  congestions,  which  were  an- 
nounced by  dyspnoea,  a  sense  of  oppression,  and  rales  of 


APPENDIX.  231 

various  kinds.  This  pectoral  complication  of  typhus 
was  generally  more  grave  and  deadly  in  its  effects  than 
the  abdominal  and  encephalic.  Sometimes  the  pulse 
was  full,  hard,  and  frequent,  especially  at  first ;  and  at 
other  times  it  was  small,  sharp,  quick  (a  hundred  and 
thirty  to  the  minute),  and  often  maintained  itself  in  this 
condition  till  the  end  of  the  disease.  In  most  instances 
it  was  weak  and  languid,  and  in  grave  cases,  towards 
the  close,  it  was  thread-like,  and  scarcely  perceptible. 
It  however  varied  considerably,  according  to  the  con- 
stitution of  the  individual. 

"Nasal  haemorrhages  were  common  in  cases  of  typhus, 
rarely  appearing  before  the  fourth  day,  and  still  more 
rarely  showing  themselves  in  the  premonitory  stage, 
when  such  occurred,  or  at  the  beginning  of  the  disease, 
as  in  typhoid  fever.  The  mean  duration  of  this  malady 
might  perhaps  be  estimated  at  eight  days ;  frequently  it 
terminated  at  the  end  of  the  first  week,  and  rarely  went 
beyond  the  second.  Grave  cases  of  typhus,  which  were 
prolonged  beyond  this  period,  oftentimes  relapsed  into 
conditions  very  similar  to  those  of  typhoid  fever.  The 
mouth  became  dry,  the  tongue  and  gums  were  covered 
with  sordes,  the  bowels  were  inflated,  the  right  iliac 
fossa  was  painful  and  the  seat  of  a  manifest  crepitation, 
and  at  length  a  diarrhoea  appeared.  At  a  still  later 
period,  coma  supervened,  with  a  general  loss  of  sensi- 
bility and  the  functions  of  the  senses,  thus  completing  a 
striking  resemblance  between  the  two  diseases.  Fre- 
quently the  typhus  ended  as  suddenly  as  it  began  ;  in 
fact,  it  is  not  a  rare  thing  to  find  the  Eisease  all  at  once 
become  aggravated,  and  terminate  in  death  in  a  few 
hours,  while  very  severe  cases  would  as  suddenly  amend, 
and  return  quickly  to  health.  In  a  considerable  number 
of  cases  of  typhus,  we  have  seen  the  malady  attended 
with  fetid  sweats  having  an  odor  of  rotten  straw,  and 
with  intestinal  fluxes  and  parotitis.  These  abscesses  in 
the  parotid  glands  have  more  than  once  modified  the 
progress  of  the  disease  in  a  favorable  manner,  especially 
in  the  case  of  a  young  aide-major,  M.  Garny,  whose 
recovery  from  a  severe  attack  of  typhus  was  not  really 
determined  until  the  appearance  of  an  abscess  of  this  kind. 


232  APPENDIX. 

"  No  matter  what  cause  induced  a  favorable  termina- 
tion of  this  disease,  the  convalescent  returned  rapidly  and 
steadily  to  health,  thus  presenting  a  contrast  with  the 
slow  and  almost  fatal  irregularity  of  typhoid  fever. 
This  difference  in  the  progress  of  convalescence  may  be 
explained  by  the  diversity  of  the  intestinal  lesions  exist- 
ing in  the  two  diseases.  Thus,  in  cases  of  typhus  end- 
ing fatally,  after  an  attack  of  a  person  in  full  health,  we 
simply  find  along  the  intestinal  canal  some  red!  and  yel- 
low discolorations  in  patches  or  bands,  and  numerous 
arborescent  injections  of  the  mucous  membrane,  a  few 

Eimples,  and  some  of  Peyer's  glands,  pointed  or  retieu- 
ited ;  a  condition  which  we  constantly  find  in  a  multi- 
tude of  different  diseases,  and  which  cannot  be  regarded 
as  a  constant  pathological  character.  We  have  never 
observed  the  glands  honey-combed,  fungous,  pustulous, 
ulcerated,  or  gangrenous,  nor  the  mesenteric  ganglia 
engorged,  nor  any  of  the  other  special  lesions  of 
typhoid  feVer. 

"  This  disease,  of  which  we  have  enumerated  the  prin- 
cipal symptoms,  has  a  strong  tendency  to  spread  from 
one  patient  to  the  next.  Thus  we  have  seen  it,  in  our 
wards,  communicate  from  the  first  patient  to  his  nearest 
neighbors,  and  so  on  from  them  to  the  attendants,  the 
sisters  of  charity,  and  the  physicians.  We  have  met  it 
in  persons  whose  age  would  be  considered  as  a  protec- 
tion against  an  attack  of  typhoid  fever,  and  with  young 
men  who  are  well  known  to  have  been  attacked  and 
to  have  been  cured  (Messrs.  Lardy  and  Laval,  Aides- 
Major). 

"These  facts  should  be  considered  sufficient  to  establish 
the  nature  of  typhus,  and  prevent  it  from  being  con- 
founded with  typhoid  fever.  If,  furthermore,  it  did  not 
differ  essentially  from  it — 

"  1st.  In  the  manner  of  attack  and  progress,  the 
absence  of  premonitory  symptoms  in  almost  all  cases, 
and  the  sudden  appearance  01  nervous  symptoms,  which 
rapidly  reach  their  state  of  greatest  intensity. 

"  2d.  In  the  form,  period,  and  duration  of  the  exan- 
thematous  eruption. 

"  3d.  In  the  period  of  the  appearance  of  epistaxis. 


APPENDIX.  233 

"  4th.  In  the  frequent  absence  of  disturbances  in  the 
region  of  the  bowels. 

"  5th.  In  the  shortness  of  duration. 

"  6th.  In  the  rapidity  of  convalescence. 

"  7th.  In  the  frequent  occurrence  of  parotitis. 

"  8th.  In  the  difference  of  the  pathological  changes 
observed  in  the  two  diseases. 

"  This  epidemic  typhus,  after  being  a  long  time  sta- 
tionary^ has  suddenly  assumed  very  considerable  pro- 
portions. During  the  first  fifteen  days  of  January,  the 
number  of  patients  tainted  with  the  disease  was  not  over 
a  hundred,  but  now  it  has  arisen  to  sixteen  hundred.  It 
has  thus  far  spared  the  officers  of  the  army;  but,  on  the 
other  hand,  it  has  raged  cruelly  among  the  surgeons, 
the  sisters  of  charity,  the  chaplains,  and  the  attendants 
belonging  to  the  field  and  general  hospitals.  Of  the 
physicians  treated  for  this  disease  in  the  hospital  at  the 
Russian  embassy,  eight  are  in  a  most  serious  and  alarm- 
ing condition.  They  are  Messrs.  Girard,  de  Santi ;  Mil- 
4emberger,  Arondel,  Rioublanc,  majors  and  aides-majors 
of  the  field  hospitals ;  and  Volage,  principal,  Cornac, 
major,  and  Bauchet,  aide-major  of  the  general  hospitals. 
Since  the  last  of  January,  we  have  had  Messrs.  Dulac, 
Savaete,  and  Lardy.  Several,  whose  names  I  do  not 
know,  succumbed  to  the  disease  at  Eupatoria  and 
Sebastopol. 

"  Your  hygienic  prescriptions  to  insure  the  salubrity 
of  our  hospitals  have  been  carried  into  effect.  At  your 
instance,  a  depot  of  convalescents  has  been  opened,  and 
the  new  localities  have  been  prepared  for  the  accom- 
modation of  five  thousand  sick,  with  the  view  of  scatter- 
ing them,  and  thus  prevent  encumbrance  in  the  existing 
hospitals.  The  food  of  the  sick  has  been  modified  and 
adapted  to  the  wants  of  the  patients  whom  we  treat ; 
and  there  is  reason  to  hope  that  these  wise  measures 
will  eradicate  the  disease,  and  that  we  shall  soon  be  able 
to  announce  an  amelioration  in  our  general  condition  of 
health." 

11* 


234  APPENDIX. 


VIII. 

Instructions  relative  to  the  establishment  of  a  Dtpot  of 
Convalescents,  in  apart  of  the  Camps  at  Maslak. 

1.  ORGANIZATION. — The   convalescents  shall   be  di- 
vided by  sections  and  arms,  as  much  as  possible,  the 
effective  maximum  being  200." 

2.  The  sections  shall  be  commanded  and  managed  by 
lieutenants,  or  sub-lieutenants,  having  under  them  sub- 
officers  and  corporals.     They  shall  each  be  taken   from 
among  the  convalescents,  or  in  default  of  these,  from 
the  84th  line,  which  regiment  shall  always  furnish  for 
each   section,  the   sub-officer   and   corporal   who   shall 
perform    the   duties    of    sergeant-major    and   quarter- 
master. 

3.  A  captain,  selected  from  the  84th,  shall  exercise 
supervision  over  the  officers  of  the  section  in  all  that 
relates  to  discipline,  internal  police,  orderlies,  etc.,  and 
shall  sign  for  the  various  sections,  such  papers  as  orders 
for  purchase,  bills,  etc.     He  shall  be  responsible  to  the 
council  of  the  administration  of  the  corps,  with  whom 
he  is  to  confer  directly,  with  regard  to  administrative 
affairs. 

4.  ADMINISTRATION. — The   sections   shall   be  placed 
under  the   general   supervision  of   a  superior    officer, 
taken  from  the  84th,  who  shall  direct  the  general  service, 
secure  a  proper  discipline,  and  employ  the  captain  as 
his  intermediary  for  transmission  of  his  orders. 

5.  INTERIOR  REGULATIONS. — Each  section  shall  form 
an  administrative  unity,  in  the  same  manner  as  the  com- 
panies of  a  corps. 

6.  The  sections  shall  mess  separately. 

7.  The  mess  expenses    shall  be  the  same  as  in  the 
regular   army  corps.     There   shall  be  added  a  supple- 
mentary sum  of  five  centimes  (a  cent)  a  day,  which  shall 
be  devoted  exclusively  to  the  purchase  of  fresh  or  pre- 
served vegetables. 

8.  There    shall    be  allowed  to    each    sub-officer  and 
soldier  present,  including  those  charged  with  the  com- 


APPENDIX.  235 

mand,  a  ration  of  wine  daily,  in  addition  to  the  regular 
ration  of  sugar  and  coffee. 

9.  The  rations  of  provisions  shall  consist  exclusively 
of  bread,  fresh  meat,  rice  or  dried  vegetables,  salt,  sugar 
and  coffee,  at  fixed  prices,  and  the  lixed  allowance  of 
fuel. 

10.  The  additional  ration  of  wine  shall  be  distributed 
one  half  at  each  meal. 

11.  The  ration  of  sugar  and  coffee  shall  be  issued  at 
about  eight  o'clock  in  the  morning. 

12.  BARRACKS  AND  ENCAMPMENTS. — The  convalescents 
shall  be  placed  in  barracks  instead  of  tents,  and  these 
shall  be  furnished  with  stoves. 

13.  To  each  man  there  shall  be  allowed  a  mattress  and 
a  bolster,  which  shall  be  placed  upon  the  camp  beds. 

14.  In  the  absence  of  camp  beds,  trestle  bedsteads  of 
wood  shall  be  furnished. 

15.  The  men  shall  be  provided  with  camp-blankets. 

16.  The  utensils  and  other  furniture  for  this  service, 
will  be  furnished  from  the  public  stores  upon  the  order 
and  responsibility  of  the  corps  to  which  the  men  belong. 

17.  SANITARY  SERVICE. — The  sanitary  service    shall 
be  intrusted  to  a  physician  of  the  grade  of  major,  who 
shall  be  designated  by  the  chief  physician  of  the  service 
of  the  hospitals  at  Constantinople.     He  will  be  assisted 
by  one  or  more  aides-major,  according  to  the  wants  of 
the  establishment. 

18.  The  men  shall  be  taken  out  to  walk,  according  to 
the  direction  of  the  chief  physician,  who  shall  limit  the 
time,  and  if  need  be,  shall  cause  the  feebler  ones  to  be 
attended  by  an  aide-major. 

19.  A  sanitary  visit  shall  be  made  weekly,  and  those 
who  are  deemed  able  to  rejoin  the  service,  will  be  sent 
to  their  corps.     Pleasant  days  are  to  be  selected,  as  far 
as  practicable,  for  sending  them  off. 

20.  Such  men  as  prove  tp  be  incapable  of  complete 
recovery  at  the  depot  of  convalescents,  may,  according 
to  circumstances,  be  sent  to  the  hospital,  or  be  allowed 
sick  leave,  or  be  sent  to  the  depot  of  their  corps.     Jn 
these  two  latter  cases,  the  major-physician  charged  with 
the  duty,  shall  furnish  certificates  of  visit,  which  visit 


236  APPENDIX. 

shall  be  made  by  the  chief  physician  of  the  health  ser- 
vice, in  the  presence  of  the  Brigadier  General. 

21.  The   barracks   shall  be  warmed   only  when  the 
major-physician  may  deem  it  necessary. 

22.  One  or   more  barracks    shall  be  placed   at  the 
service  of  the   major-physician,    to  be  used  as  a  regi- 
mental infirmary. 

23.  The  medicines  and  dressings  necessary  for  use  in 
the  infirmary,  shall  be  supplied  from  the  public  stores, 
to  be  charged  against  the  funds  of  the  corps  that  may 

-require  them. 

24.  FOEMATION  or  THE  DEPOT — Sending  to  the  Hos- 
pitals.— The  depot  for  convalescents  shall  be  opened  on 
the   first  of  February  next,  and   instructions  shall  be 
issued  in  time  to  enable  the  chief   physicians   of  the 
hospital  service,  and  other  accountable  officers,  to  select 
and  send  to  Maslak  such  men  as  they  may  deem  proper 
to  be  admitted.     Those  whose  duty  it  is  to  report  lists 
of  names,  shall  indicate  the  number  of  the  regiment,  the 
Christian  and  family  name,  and  the  rank,  and  they  shall 
be  classified  as  infantry,  cavalry,  artillery  and  engineers, 
and  other  arms.     These  lists  shall  be  addressed  to  the 
military  intendant,  on  the    28th  instant,  and  shall  be  at 
once    sent  to    the   general    commanding   the  military 
division. 

25.  The  hospitals  shall  send  their  men  upon  the  first 
fprmation  of  the  depot,  in  the  following  order : 

February  1st,  Pera,  Dolma-Batche,  Military  School, 
and  Parade-ground  Hospitals. 

February  2d.    Gulhane  and  the  University  Hospitals. 

February  3rd.  Daoud-Pacha,  Maltepe,  and  Kamis 
TchhTlick  Hospitals. 

26.  The  first  formation  shall   embrace  a   section  for 
each  arm  and,  if  need  be,  two  from  the  Infantry, 

27.  The  sections  shall  form  a  single  series  of  numbers, 
and  the  designation  of  the  arm  shall  be  added  to  the 
number  of  each  section. 

28.  After  the  first  formation,  the  hospitals  shall  send 
only  upon  certain  days  of  the  week,  viz  : 

Monday — Gulhan6  and  the  University  Hospitals. 
Wednesday— Pera  and  Dolma-Batche  Hospitals. 


APPENDIX.  237 

Thursday — Military  School  and  Parade-ground  Hos- 
pitals. 

Saturday-*-Daoud-Pacha,  Maltepe,  and  Kamis-Tchiff- 
lick  Hospitals. 

In  case  of  bad  weather,  the  sending  may  be  delayed 
till  the  next  day,  or  to  the  day  named  in  the  week 
following. 

29.  The  selections  shall  be  made  by  the  chief  physi- 
cians, at  least  forty-eight  hours  before  sending.     Lists, 
including  details  mentioned  in  Article  24,  and  arranged 
according  to  the  arms,  shall  be  sent  to  the  chief  of  the 
staif,    on   the  day  before  the  day   designated   for  the 
removal,  in  order  that    the  commander  of  the  depot 
may  be  prepared  in  time. 

30.  Such  men  as  are  known  by  the  major-physician 
to  be  unable  to  walk  the  distance,  may  be  sent  in  chairs 
or  arabas,  according  as  may  be  most  convenient. 

31.  In  all  cases  the  Administration  will  take  charge 
of  the  transportation  of  all  property  belonging  to  the 
men,  sent  to  the  depot. 

32.  Each  man  sent  by  the  hospitals  to  the  depot  shall 
be  furnished  with  a  ticket  of  discharge,  which  shall  be 
at   once  sent  to  the  major-physician,    and   by  him  re- 
turned to  the  men  when  they  are  sent  to  the  stations 
of  their  corps.     The  tickets  of  the  men  entered  at  the 
hospital  or  sent  to  France,  shall  be  lodged   with  the 
captain  performing  the  duties  of  military  sub-intendant, 
who   shall  forward  them  to  the  smaller  depots  of  the 
corps,   at  the  same   time  notifying  the  depots  of  the 
present  location  of  the  men. 


IX. 

Report  to  Marshal  Pelissier. 

CRIMEA,  GENERAL  QUARTERS,  March  15,  185G. 

"  To  HIS  EXCELLENCY,  THE  MARSHAL  : 

"  I  have  hastily  passed  through  a  part  of  the  camps 
and  field  hospitals,  and  without  further  delay,  consider 


238  APPENDIX. 

it  my.  duty  to  inform  your  Excellency  of  my  opinion,  as 
to  the  sanitary  condition  of  the  army. 

"The  first  point  which  I  wish  to  determine,  was, 
whether  typhus  prevailed  in  the  field  hospitals  only,  or 
whether  it  was  also  prevalent  in  the  regiments.  To  be 
convinced  of  the  latter,  it  was  only  necessary  to  attend 
the  morning  visit  when  the  men  presented  themselves 
at  the  regimental  infirmaries.  To  the  inexperienced 
eye,  the  premonitory  symptoms  of  typhus  may  be  con- 
founded with  those  of  other  diseases,  and  some  of  our 
physicians  did  so  mistake  them  at  first,  but  in  the 
hospital  all  doubt  quickly  vanishes.  To  the  initial 
chills,  with  headache,  succeeds  a  dulness  and  stupor, 
which  distinguishes  typhus  as  plainly  as  the  symptoms 
of  cholera,  which  can  no  longer  be  mistaken.  The  pro- 
duction of  typhus  in  the  midst  of  regiments,  is  a  serious 
fact,  and  unhappily  as  well  established  as  the  fact  of  its 
propagation  by  infection.  Two  great  indications  pre- 
sent themselves  here :  first,  prevent  its  spread  among 
the  masses ;  and  second,  remove  the  causes.  The  mea- 
sures to  prevent  the  spread  of  typhus  among  the  troops, 
are  simple,  and  easy  to  put  in  execution. 

"It  is  only  necessary  to  carefully  watch  that  no  patient 
infected  with  the  disease  shall  be  allowed  to  remain 
either  in  the  tents  or  in  the  regimental  infirmaries,  and 
to  send  the  soldiers,  on  the  first  appearance  of  the 
symptoms,  to  the  field  hospitals. 

"  The  importance  of  this  counsel  will  be  appreciated 
when  it  Is  remembered  that  human  miasm  does  not 
appear  to  be  contagious  until  the  expiration  of  several 
days  of  sickness,  and  above  all,  at  the  period  of  the 
critical  sweats. 

"  The  preventive  measures  to  be  applied  in  the  regi- 
ments, are  as  follows,  and  observe,  Marshal,  that  I  shall 
only  recommend  such  as  are  within  our  resources,  and 
those  which  your  Excellency,  with  wise  forethought,  has 
given  to  the  army. 

"Awaiting  the  return  of  fine  and  settled  weather,  to 
allow  of  changing  the  site  of  all  the  camps,  the  soil  of 
which  is  deeply  impregnated  with  impurities,  it  would 
be  well,  as  often  as  the  weather  permits,  to  take  down 


APPENDIX.  239 

the  tents,  or  at  least  to  draw  up  the  circular  curtain  as 
high  as  the  safety  cords  will  permit.  This  operation, 
which  'I  have  often  witnessed,  can  be  easily  accomplished 
if  the  tent-pins  are  four  or  five  inches  above  the  ground. 
Six  men  occupied  five  or  six  minutes  in  completing  it. 
Furthermore,  recourse  should  be  had  to  this  hygienic 
measure,  which  serves  to  ventilate  and  dry  the  ground, 
always  damp,  if  not  actually  muddy,  whenever 'it  does 
not  rain  or  snow ;  and  for  a  stronger  reason,  when  the 
sun  shines,  and  when  a  fine  breeze  is  blowing. 

"  In  order  to  secure  the  punctual  execution  of  this 
prescription  in  the  15,000  to  20,000  tents,  it  should  be 
indicated  by  drum-roll  in  the  morning,  when  the  men 
get  up,  and  in  the  evening  at  the  time  of  retiring..  It 
would  have  the  effect  of  preventing  the  soldiers  from 
remaining  the  greater  part  of  the  day  in  their  tents, 
which  they  keep  hermetically  closed,  even  in  the  finest 
weather — such  as  we  have  had  for  the  last  three  days. 
It  is  quite  enough  to  have  them  closed  at  night,  and  to 
be  obliged  to  breathe  a  contaminated  air  during  sleep. 

"  The  ground  of  the  tents,  once  dry,  should  receive  a 
coat  of  lime,  which  would  harden  and  purify  it. 

"The  blankets  and  articles  of  clothing  should  be 
hung  out  in  the  sun,  as  soon  as  it  appears,  so  as  to  dry 
out  the  dampness  and  purify  them.  Those  which  have 
been  used  by  typhic  patients  should  be  subjected  to 
several  chlorine  fumigations,  before  being  again  put  to 
use. 

"  As  soon  as  the  weather  permits,  the  shelter  tents 
should  be  removed  to  another  location.  These  tents 
have  not  only  the  advantage  of  affording  to  the  inmates 
a  sufficient  protection  from  rain  and  atmospheric 
changes,  but  allow  the  air  inside  to  be  renewed  by 
the  passage  of  fresh  air  through  the  interstices  of  the 
fabric. 

"A  great  number  of  the  regimental  infirmaries  are 
badly  arranged.  Instead  of  two  barracks,  many  have 
only  one.  The  men  are  not  always  protected  from  con- 
tact with  the  damp  ground  by  camp-bedsteads,  or  even 
planks.  The  barracks  ought  to  be  whitewashed  inside 
and  out,  and  often  fumigated.  Why  not  supply  all  of 


240  APPENDIX. 

them  with  the  little  wooden  frames,  like  those  in  the 
infirmary  of  the  81st  of  the  line,  which  is  a  model  of 
good  arrangement,  and  those  which  are  supplied  to  the 
sub-officers  and  to  the  soldiers  of  the  guard?  The  air 
circulates  freely  underneath  these  little  sort  of  litters,  and 
when  possible,  they  might  be  covered  with  a  sack  of  hay 
or  straw,  as  in  the  barrack  of  the  81st  of  the  line,  which 
provides  a  good  bed.  Since  I  have  spoken  of  the  81st 
of  the  line,  I  will  further  say  that  I  experienced  great 
satisfaction  at  witnessing  the  fine  hygienic  arrange- 
ments in  the  tents  of  this  regiment.  Each  soldier  has  a 
separate  camp-bedstead  and  a  mattress  ;  cleanliness  per- 
vades everywhere,  and  we  may  ask  why  the  care  be- 
stowed by  the  officers  on  the  men  in  this  instance, 
should  not  be  emulated  by  all  the  others.  The  results 
of  such  a  system  are  that  the  81st  haye  an  effective 
strength  of  2,400  men,  ready  at  a  moment's  notice  to 
encounter  the  fatigues  of  war. 

"Food. — All  the  food,  with  the  exception  of  the  fresh 
beef,  is  good.  The  beef  is  flaccid  and  gluey ;  the  ani- 
mals are  reduced  to  a  state  of  marasmus  when  killed, 
and  their  flesh  affords  but  slight  nourishment;  but  this 
eventually  has  been  anticipated  by  the  solicitude  of  the 
government.  In  the  absence  of  fresh  meat  we  have 
excellent  preserved  beef  of  the  first  quality.  If  the  sup- 
plies permit  of  it,  I  think,  sir,  that  the  ration  of  preserved 
meat  might  be  augmented  one-sixth.  This  measure,  as 
well  as  that  already  taken,  of  supplying  a  daily  supple- 
mentary ration  of  wine,  seems  to  me  useful,  as  long  as  we 
are  subject  to  typhus,  to  strengthen  the  systems  of  the 
men  against  the  attack  of  the  epidemic. 

"  I  do  not  speak  of  the  powdered  meat,  which  is  con- 
sidered very  inferior  to  the  preserved  beef. 

"  I  am  surprised  that  no  effort  is  made  to  use  the  flesh 
of  the  horses  that  are  condemned  to  be  killed.  To  over- 
come prejudice  the  example  should  be  set  by  those  in 
authority.  A  commencement  might  be  made  by  distri- 
buting horse  flesh  to  the  officers.  The  generals  might 
set  the  example  by  inviting  the  colonels  to  a  dinner  of 
horse  flesh.  This  flesh  is  far  preferable  to  the  beef 
which  we  have  here.  If  I  did  not  fear  that  the  use  of  it 


APPENDIX.  241 

would  affect  the  spirits  of  the  patients,  I  would  recom- 
mend it  in  the  field  hospitals. 

"  The  spring  will  bring  with  it  the  invaluable  dande- 
lion. Meanwhile  it  would  be  well  to  encourage  the 
excellent  measures  of  the  Minister  of  War  for  the  ship- 
ment of  large  quantities  of  the  fresh  vegetables  which 
abound  at  Constantinople. 

"  Work  and  moderate  exercise  are  excellent  aids  to 
health.  Nothing  is  more  pernicious  than  absolute  rest ; 
idleness  enervates  the  body  and  soul. 

"  Collections  of  rubbish  have  been  allowed  to  accu- 
mulate around  some  of  the  camps  ;  they  should  be  cart- 
ed away,  as  soon  as  possible,  by  well  directed  fatigue  par- 
ties. The  moment  for  redoubling  care  and  cleanliness 
has  arrived  ;  the  slightest  violation  of  hygienic  laws  will 
increase  the  number  of  sick  and  deaths. 

"  For  the  time  being,  I  confine  my  counsels  to  the 
regiments,  to  these  few  and  simple  measures. 

"Ambulances. — You  are  aware,  sir,  that  notwithstand- 
ing our  united  efforts,  we  have  been  unable  to  give  our 
ambulances  a  good  hospital  status.  • 

"  Of  the  6,000  mattresses  put  in  use  four  months  ago, 
there  are  hardly  2,500  which  are  serviceable,  and  it  is 
with  difficulty  that  the  repairs  are  made  in  time  to 
maintain  this  number. 

"  The  barracks  are  only  sufficient  for  4,500  inmates. 

"  Blankets  are  numerous,  but  almost  all  of  them  con- 
taminated; sheets  are  wanting,  as  well  as  means  for 
thorough  washing.  Many  of  the  sick  are  obliged  to 
sleep  in  their  trowsers.  There  are  not  sufficient  camp 
beds  for  the  tent  hospitals,  and  many  utensils  are  want- 
ing, such  as  chambers,  broth  bowls,  spittoons,  etc.,  and 
above  all  the  slippers  and  hospital  clothing. 

"  I  am  not  criticising ;  far  from  it.  I  am  the  first  to 
acknowledge  the  great  difficulties  which  have  been 
overcome,  before  arriving  at  the  present  result.  Be- 
sides, it  must  not  be  forgotten  that  we  are  carrying  on 
a  campaign  in  a  country  destitute  of  everything  ;  I  have 
only  wished  to  prove  the  facts,  and  show  that  it  is 
urgently  required  that  the  greatest  number  possible  of 
our  sick  should  be  sent  to  Constantinople,  in  order  to 


242  APPEXDIX. 

disencumber  our  field  hospitals  here.  If  it  were  neces- 
sary to  demonstrate  it  by  figures,  I  could  find  it  in  the 
afflicting  results  furnished  by  the  sick  treated  in  the 
Crimea,  during  the  last  few  weeks. 

"  During  the  last  ten  days,  from  the  20th  to  the  29th 
of  February,  which  is  a  good  sample  of  the  same  period 
for  a  long  time  back,  519  left  the  ambulances  cured,  and 
873  died  ! !  A  comparison  in  the  cases  of  typhus  gives 
a  still  more  terrible  result.  For  every  27  cures  we  have 
383  deaths,  and  yet,  sir,  typhus  in  its  ordinary  condi- 
tion^ although  a  serious  disease,  does  not  carry  off  more 
than  a  sixth  of  the  sick.  For  example,  of  442  infirmary 
attendants  attacked  with  typhus  at  Constantinople,  only 
42  died. 

"  These  figures  do  not  require  comment ;  they  loudly 
testify  to  the  impotency  of  medicine,  in  the  conditions 
found  in  the  Crimea. 

"  Ought  all  the  sick  to  be  sent  to  Constantinople,  or 
only  a  certain  class  ?  My  advice  is,  to  ship  off  all  the 
non-typhic  patients,  if  their  condition  allows  of  it ;  they 
are  the  most  numerous.  Their  departure  will  effect  an 
immediate  disencumbrance  of  the  hospitals  and  allow  all 
the  energies  and  care  of  the  surgeons  to  be  devoted  to 
the  unfortunate  typhic  patients,  who,  retained  in  the 
Crimea,  will  no  longer  risk  the  fleet  and  the  hospitals  of 
Constantinople  with  the  dangers  of  infection. 

"  If  the  weather  continues  favorable,  it  would  be  ad- 
visable to  place  the  typhic  patients  in  tents,  pitched  at 
distances  of  15  yards  apart,  and,  if  our  resources  will 
permit  of  it,  to  instal  only  two  patients  in  each  tent ; 
they  should  not  be  allowed  to  lie  on  the  ground,  but  be 
provided  with  camp  beds,  by  this  means  they  would  be 
protected  from  the  unhealthy  influence  of  the  lower 
stratum  of  the  air ;  the  bed  clothing  should  be  changed 
daily,  and  exposed  to  fumigating  agents ;  whitewash  the 
ground,  fumigate,  constant  change  of  air,  for  I  again 
repeat,  contagious  typhus  must  have  pure  air,  constantly 
renewed,  without  which  cure  is  impossible. 

"  You  see,  sir,  military  medicine  is  not  very  exacting, 
it  can  bend  itself  to  the  necessities  of  war ;  but  the  little 
we  ask  should  be  given  without  grudging. 


APPENDIX. 


243 


"  One  of  the  grave  considerations  occupying  M.  Scrive 
and  M:  Mery,  Xledical  Director  of  the  3d  corps,  is  the 
sanitary  condition  of  the  two  field  hospitals,  that  of  the 
2d  division  of  the  2d  corps,  in  which  the  mortality  at 
the  present  moment  is  very  great,  and  that  of  the  two 
first  divisions  of  the  reserve.  I  visited  the  last.  Among 
the  600  sick,  I  found  319  cases  of  typhus  in  very  deplo- 
rable conditions,  so  deplorable  that,  in  my  opinion,  the 
immediate  abandoning  of  the  hospital  can  alone  bring 
any  remedy. 

"  Your  Excellency  can  judge  for  yourself  from  the 
statement  given  below,  handed  to  me  by  M.  Goutt, 
Medical  Director  of  this  ambulance. 

'-'•Field  hospital  of  the  first  division  of  the  reserre 
corps  (3d  corps). 

"Return  of  cases  of  typhus,  from  the  10th  of  January 
to  the  10th  of  March,  1856. 


Period. 

Entered. 

Left. 

Sent  away. 

Died. 

January    10  to  20. 

65 

0 

4 

10 

20  to  30. 

. 

18 

0 

30 

30 

February    1  to  10. 

184 

4 

149 

61 

"         10  to  20. 

t 

313 

0 

6 

133 

"         20  to  29. 

137 

0 

52 

93 

March         1  to  10. 

, 

120 

0 

0 

101 

Total. 


837 


241 


428 


"  Of  these  837  cases  of  typhus,  531  were  sent  directly 
from  the  regiments,  and  306  were  developed  in  the  field 
hospital  in  the  following  proportion  : 


Chaplains 1 

Administrative  officers 0 

Attendants 85 

Laborers  . .  25 


Sick  who  entered  from  other 

diseases. 185 

Physicians 10 


"  The  return  of  pleasant  weather  will,  doubtless,  mo- 
dify in  a  favorable  degree,  this  unfortunate  condition, 
but  the  sun  alone  cannot  accomplish  all.  We  must  come 
to  its  aid,  and  second  its  influence  with  our  own  efforts, 
if  we  wish  to  make  sure  of  enjoying  its  benefits. 

"  The  typhus  of  last  year  never  presented  the  grave 
characters  of  the  present  attack.  In  the  opinion  of  some 


244 


APPENDIX. 


Effective 
Strength. 
78  000 

April 

Deaths. 
615 

Effective 
Strength. 
91,000 

89000 

Mav 

.    .     1  075 

107,000 

96,000 

jM.«*y 

June  .  . 

.   3.106 

121,000 

physicians,  it  did  not  then  even  exist,  but  now,  no  one 
doubts  its  presence.  The  following  total  of  deaths  dur- 
ing the  first  six  months  of  1855,  in  the  field  hospitals  of 
the  Crimea,  is  highly  instructive.  It  will  be  seen  that 
the  sun  gave  more  activity  to  the  emanations  of  organic 
miasms,  and  did  not  reduce  the  number  of  deaths,  as  we 
hoped  it  would. 

Deaths. 

January 971 

February 543 

March 500 

"  The  last  figures  embrace,  it  is  true,  a  large  number 
of  deaths  from  cholera.  In  the  above  table,  the  deaths 
from  wounds  received  in  action,  form  but  an  insignifi- 
cant part.  In  disclosing  the  sanitary  condition  of  the 
army,  loyally  and  as  it  actually  exists,  I  feel  that  I  have 
only  done  my  duty.  The  situation  is  serious,  but  we 
can  still  control  it,  and  your  Excellency  will  surely  tri- 
umph, if  the  simple  measures  proposed  are  adopted. 
The  mortality  is  very  considerable,  amounting  to  five  or 
six  thousand  men  a  month,  in  the  Crimea  and  at  Con- 
stantinople. It  has  hitherto  mocked  the  wisest  precau- 
tions ;  the  burden  of  blame  must  be  borne  by  the  evils 
which  war  entails.  The  powerful  assistance  which  your 
Excellency  has  rendered  to  the  medical  officers  of  the 
army,  of  whom  nineteen  have  already  died  of  typhus, 
and  the  high  degree  of  confidence  with  which  the  pro- 
fession has  been  honored  and  encouraged,  have  ever 
elevated  its  devotion  and  self-denial,  and  impressed  me 
personally  with  the  deepest  gratitude." 


X. 

Report  of  Dr.  Marcet,   Chief  of  the  Medical  /Service 
at  Calchi. 

NAVAL  HOSPITAL  AT  CALCHI,  April  10,  1856. 

"  INSPECTOR  BAUDENS  :    SIR — I  have  the  honor,  in 
addressing  you,  to  respond  to  your  wish,  that  I  would 


APPENDIX.  245 

submit  some  notes  upon  the  typhic  affections  that  pre- 
vailed in  the  hospital  at  Calchi,  from  the  latter  part  of 
December,  1855,  to  the  12th  of  April,  1856.  You  will 
please  pardon  the  brevity  of  my  statements,  in  view  of 
the  numerous  engagements  of  the  present  time. 

"I  have  had  under  treatment  sailors  attacked  with 
the  typhus  in  the  following  order  : — 

From  the  ship  Wagram 2*7  *j 

"       "      "     Vauban 13  [January 

Sick  attacked  in  the  hospitals,  particularly  scorbutic        (and  Feb. 
patients 32  J 

From  the  ship  Orenoque 119  ] 

"       "      "     Algeria 129 

*'      "      "     Magellan,  for  the  most  part  convales-        I  ,.-     , 

cent 60  H      rch> 

"       "      "     Lucifer 13 

Sick  attacked  in  the  hospital 58 

Total  (of  whom  64  died)  . . .  .446,  or  one 
death  in  seven. 

"  I  attribute  the  very  large  proportion  of  sick  from 
the  Algeria  and  the  Orenoque  to  the  fact,  that  these 
ships  were  obliged  to  keep  their  sick  ten  or  twelve  days 
on  board,  during  a  cold  and  rainy  period,  which  com- 
pelled all  the  passages  for  ventilation  to  be  closed.  It 
is  worthy  of  remark,  that  the  Algeria  alone  had  any  of 
its  officers  sick  (five,  one  of  whom  was  the  comman- 
dant). The  berths  of  the  officers  of  sailing  frigates  are 
between  decks,  and  have  no  air  but  what  comes  from, 
the  gun-deck,  where  the  sick  passengers  lie.  The  com- 
mandant, whose  berth  was  in  the  after  part  of  the  gun- 
deck,  owed  his  sickness  to  his  humanity.  He  had  given 
up  a  part  of  his  cabin  to  the  passengers,  and  lived  in  the 
midst  of  the  most  severe  cases.  The  masters  of  all  the 
ships  pay  a  large  tribute  to  the  disease  being  lodged  in 
the  lower  parts  of  the  vessel. 

"  The  period  of  incubation  of  typhus  appears  to  me 
to  be  from  twelve  to  fifteen  days.  With  few  exceptions, 
typhus  has  presented  three  periods — premonitory,  catar- 
rhal,  and  that  which  I  shall  call  the  actual  condition, 
during  which  the  ataxic  or  the  adynamic  symptoms 
prevailed,  sometimes  both. 


246  APPENDIX. 

"The  most  general  symptom  was  the  petechial  erup- 
tion, which  was  often  of  remarkable  intensity.  It 
showed  itself  during  the  first  day,  rarely  after  the  fifth 
or  seventh.  Once  it  appeared  on  the  ninth — the  patient 
died  two  days  afterwards. 

"  Pains  in  the  head  and  epistaxis  were  the  rule.  The 
latter  recurred  five  or  six  times  in  twenty-four  hours ;  in 
three  cases  the  excessive  haemorrhage  necessitated  plug- 
ging ;  they  appeared  to  relieve  the  pains  in  the  head.  I 
observed  bloody  stools  in  only  one  case,  and  one  case  of 
ha3maturia,  followed  by  very  sedimentary  urine  and 
rapid  improvement. 

"Abdominal  symptoms  were  slightly  marked  and 
rare  (a  distinctive  character  of  typhoid  fever) ;  consti- 
pation very  frequent,  particularly  at  the  commencement. 
The  condition  of  the  lungs  deserves  great  attention  in 
the  catarrhal  period;  but,  especially  in  the  more  ad- 
vanced stages,  I  have  noticed  a  hypostatic  condition. 

"As  regards  nervous  symptoms,  I  have  found  them 
all,  from  the  simple  spasm  to  the  most  perfect  form  of 
epilepsy.  I  have  seen  one  case  of  chorea,  three  or  four 
contractions  of  the  limbs,  several  of  trismus,  of  convul- 
sions of  the  muscles  of  the  eye,  and,  finally,  tonic  con- 
vulsions of  tetanus,  or  clonic  action  of  eclampsia.  Deaf- 
ness has  been  frequently  noticed.  Delirium  has  always 
existed,  four  or  five  times  of  a  furious  kind  ;  eight  men 
were  required  to  restrain  the  patient,  in  one  case ;  the 
access  lasted  two  hours,  and  appeared  to  succumb  to 
inhalations  of  chloroform,  and  later  to  leeching  behind 
the  ears,  and  counter-irritants  to  the  lower  extremities. 

"The  progress  of  the  disease  is  incomparably  more 
serious,  when  strongly  marked  nervous  phenomena 
exist,  than  in  the  worst  stages  of  the  adynamic 
condition. 

"  I  have  observed,  as  critical  stages,  abundant  sweats ; 
they  did  not  appear  to  me  to  exercise  a  favorable  influ- 
ence ; — parotitis  (once  double)  almost  always  suppu- 
rated, good  symptom,  except  in  two  cases,  where  the 
fever  seemed  to  redouble  in  intensity,  and  caused  death 
in  twenty-four,  hours ; — abundance  of  sedimentary  urine, 
good  symptom ; — numerous  abscesses  on  the  body,  boils, 


APPENDIX.  247 

pustules  of  ecthyma,  etc. ;  but  of  all  these  symptoms  the 
sudamina  have  been  the  most  favorable — their  appear- 
ance has  always  presaged  convalescence. 

"More  than  fifty  patients  have  had  sores  on  the 
sacrum,  or  gangrenous  spots  on  the  limbs;  in  two  cases 
these  appeared  on  the  scrotum.  One  of  the  patients, 
who  seemed  to  be  convalescent,  was  affected  with 
sphacelated  ulcers  of  the  scrotum,  of  the  upper  part  of 
the  thigh,  and  of  the  perineum,  which  eat  through  into 
the  rectum  in  two  places ;  he  died.  Once  I  observed 
rapid  ulceration  of  the  two  corneas. 

"  Treatment. — At  the  beginning,  an  emetic  or  emeto- 
cathartic,  with  an  infusion  of  flax-seed.  During  the 
catarrhal  period,  diet,  sudorific  and  diluent  drinks,  a  few 
leeches  to  the  mastoid  process ;  saline  or  oily  purgatives. 
When  the  adynamic  stage  is  reached,  broth,  drink  of 
wine,  tisane,  with  melissa  or  acetate  of  ammonia,  eight 
to  thirty  grammes  in  twenty-four  hours ;  frictions  with 
camphorated  vinegar;  to  stop  involuntary  stools,  enemas 
of  hypochlorate  of  soda,  or  ratanhia,  which  is  preferable ; 
if  there  is  distension  of  the  stomach,  I  employ  campho- 
rated embrocations.  When  nervous  symptoms  predo- 
minate, I  have  employed  camphor,  musk,  ether,  but  not 
often  with  any  good  result. 

"At  the  commencement,  I  bled  twelve  or  thirteen 
men — only  one  died.  In  three  cases  the  blood  was 
covered  with  a  thick  buffy  coat." 

This  report  is  particularly  worthy  of  attention,  be- 
cause the  sailors  who  were  attacked  by  the  disease  were 
in  perfect  health,  and  of  unimpaired  constitution.  Like- 
wise, the  progress  of  typhus  has  been  more  distinct  and 
regular  in  the  crews  of  the  navy  than  in  the  worn-out 
soldiers ;  and  the  blood-letting,  which  would  have  been 
fatal  to  the  latter,  was  employed  with  benefit  to  the  for- 
mer. Bleeding  at  the  nose  has  been  more  frequent  than 
with  the  soldiers.  We  have  likewise  observed  gangre- 
nous eschar,  following  typhus,  in  the  hospitals  of  the 
land  forces.  As  to  the  furious  delirium  which  M.  Mar- 
cet  had  such  trouble  in  suppressing,  we  have  seen 
Medical-director  Garrat,  at  Daoud-Pacha,  constantly 


248  APPENDIX. 

overcome  it  with  ease  by  a  combination  of  opium  and 
sulphate  of  quinine,  administered  as  a  drink. 


XL 

Report  to  the  Minister  of  War. 

CONSTANTINOPLE,  April  28,  1856. 
"  MARSHAL  : 

"  The  excellent  manner  in  which  our  hospital  service  is 
carried  on,  reveals  itself  in  results  more  and  more  satis- 
factory. The  mortality  decreases  notably,  and  at  the 
same  time  the  cures  are  on  the  increase.  Medicine  is 
not  alone  in  congratulating  itself  upon  a  condition  so 
advantageous  to  the  success  of  its  therapeutics.  Sur- 
gery also  is  benefited  thereby.  Amputations,  especially 
those  practised  for  frost-bite,  were  almost  always  fol- 
lowed by  hospital  gangrene,  and  ended  in  death  ;  now 
they  almost  all  succeed. 

"  Some  unfortunate  fellows  whose  feet  had  fallen  off 
from  the  effects  of  frost-bite,  have  suffered  amputation 
of  both  legs,  with  perfect  success.  Our  hospital  esta- 
blishments, to  which  considerable  additions  have  been 
made,  feel  no  longer  the  influence,  so  to  speak,  of  epi- 
demics or  miasms ;  the  new  hospitals  are  nevertheless 
the  most  favored  in  this  respect.  Thus,  in  the  large 
barrack  hospital  of  Ramis-Tchifflick  there  is  compara- 
tively no  mortality,  and  no  cases  of  typhus. 

"  The  large  field  hospital  in  tents,  established  in  a  few 
days  at  Prinkipo,  is  already  full  of  scorbutic  patients, 
whose  faces  gleam  with  joy  at  finding  themselves  in 
such  healthy  quarters. 

"  Scurvy  has  been  the  precursor  of  typhus :  it  was 
urgent  to  withdraw  from  the  influence  of  this  disease 
the  scorbutic  patients  on  whom  it  throve. 

"  Four  cases  of  typhus  appeared  among  the  scorbutic 
patients;  the  seeds  of  the  disease  were  sown  in  our 
hospitals,  and  the  incubation  of  the  infectious  miasms 


APPENDIX.  249 

took  place  after  their  arrival.  I  caused  a  few  tents  to 
be  pitched  at  a  distance  of  a  quarter  of  a  mile,  and  there 
placed  the  typhic  patients.  By  these  means  we  shall 
certainly  escape  its  propagation  to  the  other  sick. 

"I  estimate  that  in  twenty  or  thirty  days  the  1,800 
scorbutic  patients  now  at  Prinkipo  will  be  sent  off,  and 
their  places  occupied  by  others.  When  the  fresh  arri- 
vals of  scorbutic  patients  cease,  we  can  begin  to  receive 
convalescents. 

"  I  intend  to  subject  the  convalescents  to  a  quarantine 
of  fifteen  days  in  another  part  of  the  island,  and  shall 
only  embark  them  for  France,  when  I  am  convinced 
after  this  lapse  of  time,  they  are  insured  against  an 
attack  of  the  reigning  epidemic. 

"Our  last  report,  up  to  the  27th  instant,  of  the 
typhus  at  Constantinople,  which  is  just  handed  to  me, 
presents  the  following  figures  : 

In  Hospital.        Entered.        Cored.        Dead, 
April  27 919  29  113  11 

"  This  result  is  very  satisfactory ;  the  comparison  of 
the  number  of  cures  with  the  deaths  fully  confirms  the 
value  of  the  precautionary  measures  before  mentioned. 

"I  think,  Sir,  that  the  subject  which  should  occupy 
our  attention  at  the  present  time,  is  the  manner  of 
transporting  the  troops  from  the  Crimea  to  France. 

"In  a  conference  with  General  Espinasse*  it  was 
decided,  in  order  to  equalize  the  distances  between  the 
Hospitals  on  the  route  followed  by  the  fleet,  that  field 
hospitals  in  tents  should  be  established  at  the  Pirea  and 
at  Messina.  Difficulties  are  placed  in  the  way  by  the 
authorities  at  the  latter  place,  who  are  opposed  to  a 
depot  for  typhic  patients  being  established  there.  We 
shall  report  on  the  Pirea  and  on  some  island  as  near 
as  possible  to  Messina. 

"I  may  be  obliged  to  visit  Greece,  to  find  a  con- 
venient depot.  The  space  assigned  to  the  present 
quarantine  ^it  the  Pirea  is  altogether  insufficient — forty 

*  The  Emperor  had  charged  General  Espiuasse,  on  his  leaving  the 
Crimea  to  return  to  France,  with  the  mission  to  inspect  the  Hospitals 
at  Constantinople. 

12 


250  APPENDIX. 

typhic  patients  would  certainly  engender  infection.  Dr. 
Artigues,  who  has  resided  for  some  time  in  this  country, 
has  given  me  valuable  information,  which  I  shall  make 
use  of.  And  although  I  hold  a  sea  voyage  in  great 
horror,  I  should  not  hesitate  to  make  it,  in  the  hopes 
that  some  service  might  result  from  it. 

"  I  am  at  this  moment  much  distressed.  My  private 
secretary,  M.  Benjamin  Crombez,  a  young  man  full  of 
courage  and  self-denial,  whose  help  is  so  valuable  to  me, 
is  suffering  from  a  severe  attack  of  typhus,  caught  dur- 
ing our  visits  to  the  hospitals.  I  pray  heaven  to  take 
pity  on  him  and  spare  me  the  pain  of  seeing  him  die  a 
victim  to  his  devotion ! 

"  I  have  this  moment  received  from  Marshal  Pelissier 
an  answer  to  my  letter  of  the  22d ;  he  tells  me  that  the 
reports  received  from  all  quarters  agree  in  showing  that 
the  sanitary  conditions  are  considerably  improved.  He 
continues  to  use  all  efforts  to  advance  this  improvement, 
for  which  happily  the  wyeather  is  favorable. 

"  I  have  always  found  the  Marshal  ready  to  listen  to 
the  counsels  of  the  physicians ;  he  gives  them  full  justice 
and  honors  them  with  his  fullest  confidence.  I  owe  to 
his  assistance  the  prompt  execution  of  the  prescriptions 
which  I  deem  indispensable. 

"I  learn  from  M.  Scrive  that  all  the  prophylactic 
measures  applied  to  the  troops  before  their  departure 
for  France,  are  faithfully  executed.  He  is  strongly 
impressed  wdth  the  danger  of  propagation  of  typhus  on 
board  of  the  transports  on  their  passage  to  France. 

"  In  one  of  his  letters,  he  says  :  '  I  yesterday  received 
a  report  from  Mr.  Molard,  director  of  the  hospital  at 
Gallipolis;  sixty-two  cases  of  typhus  have  been  landed 
from  the  ships  le  N^avarin  and  le  Jupiter,  and  yet  the 
soldiers  left  Kamiesch  and  Eupatoria  in  good  health. 
It  is  impossible  that  it  should  be  otherwise.  What 
would  have  been  the  result  if  these  vessels  had  remained 
fifteen  days  at  sea  without  touching  land  ?' 

"  From  General  de  Martimprey,  chief  of  the  staff,  I 
received  a  letter  on  the  2d  of  May,  1856,  as  follows: 

"  '  You  know,  sir,  that  we  are  improving  here,  al- 
though slowly.  Those  remaining  of  the  2d  corps,  which 


APPENDIX.  251 

is  now  embarking,  are  in  little  shelter  tents,  on  ground 
which  has  not  before  been  occupied,  and  remote  from 
the  other  encampments.  The  guard  and  the  1st  corps, 
which  are  to  embark  after,  are  subjected  to  the  same 
precautionary  measures.  On  receipt  of  your  letter  of 
the  22d  of  April,  the  most  stringent  orders  were  again 
given  for  the  punctual  enforcement  of  the  hygienic  mea- 
sures which  you  advise.  You  would  find  that  the  divi- 
sion of  the  reserve  corps,  at  this  moment  suffering  from 
typhic  infection,  is  encamped  on  the  sides  of  the  high 
mountain  which  overlooks  the  plain  of  Balaclava.' 

"  In  conclusion,  I  am  happy  to  be  able  to  assure  your 
Excellency,  that  the  epidemic  is  on  the  decrease,  and 
that  the  army  has  nearly  reached  the  end  of  its  terrible 
trials." 


XII. 

The  necessity  of  breathing  a  pure  and  continually  re- 
newed air. 

To  prove  how  necessary  pure  air  is  to  man,  as  well  as 
to  all  organized  beings,  we  shall  confine  ourselves  to  a 
few  facts  borrowed  from  some  articles  by  M.  Boudin,  in 
the  "Annales  d'Hygiene  publique  et  de  Medicine  legale" : 
"  In  1834  a  spacious  and  handsome  house  was  construct- 
ed in  the  Zoological  Gardens,  London,  intended  for  the 
monkeys,  about  30  in  number,  who  for  several  years 
past  had  lived  in  pretty  good  health,  in  the  open  air. 
The  principal  object  in  constructing  this  new  building 
was  to  provide  them  in  winter  with  an  artificial  warmth 
similar  to  that  of  their  native  clime.  A  few  weeks  after 
their  establishment  in  the  warmed  building  two-thirds 
of  them  died  by  the  disease  which  kills  the  majority  of 
our  soldiers,  pulmonary  phthisis ;  the  survivors  were  at 
the  point  of  death.  It  had  been  omitted  to  renew  the 
air  by  ventilation.  Fresh  air  was  liberally  supplied,  and 
the  monkeys  which  had  not  yet  succumbed,  soon  reco- 
vered." 


252  APPENDIX. 

The  same  author  cites  the  following  extraordinary 
occurrence:  "The  Hospital  Beaujon  in  Paris  is  com- 
posed of  four  separate  buildings,  of  exactly  the  same 
size,  and  each  containing  the  same  number  of  patients, 
suffering  from  analogous  complaints.  During  several 
years  hospital  gangrene,  erysipelas,  and  pleurisy  were 
rampant  in  three  of  the  buildings;  one  building  only 
was  exempt,  it  was  the  one  ventilated  by  the  Leon 
Duvoir  system." 

The  Council  of  Health  of  the  Army  was  consulted 
fifteen  years  ago,  on  account  of  a  murderous  attack  of 
typhoid  fever,  which  occurred  yearly  at  the  St.  Cloud 
barracks,  as  soon  as  King  Louis  Philippe  took  up  his 
residence  at  that  place.  None  of  the  inhabitants  of  the 
town  or  the  officers  were  affected,  and  as  soon  as  the 
king  left  the  place  the  epidemic  ceased.  It  was  account- 
ed for  in  this  manner :  while  the  king  was  away  the 
barracks  contained  400  men  only;  but  when  he  arrived, 
the  number  in  the  same  badly  ventilated  barracks  was 
increased  to  1,200. 

We  hasten  to  add  that  the  War  Department,  profiting 
by  the  severe  lessons  of  the  past,  has  given  strict  atten- 
tion to  the  ventilation  of  hospitals.  In  the  splendid 
military  hospital  which  has  just  been  built  at  Vincennes, 
the  apparatus  for  heating  and  ventilation  are  so  arranged 
that  each  patient  is  assured  a  minimum  of  sixty  ctibic 
yards  of  air  per  Jiour,  and  a  uniform  temperature,  day 
and  night,  of  60°  Fahr. 

These  improvements,  so  creditable  to  the  Minister  who 
has  thus  taken  the  initiative,  cannot  fail  to  secure  the 
best  results,  and  we  sincerely  hope  that  the  same  princi- 
ples will,  before  long,  be  applied  to  all  the  barracks. 


THE    END. 


INDEX. 


Acclimatization,  63. 
Acids,  vegetable,  36. 
Acrodynia,  149. 
Air,  poisoned  in  tents,  169. 
"     in  closed  cavities,  88. 
Algeria,  surgery  in,  215. 

"     hospital  gangrene,  land,  13. 
•»     ship,  245. 
Ambulances,  241. 
"     English,  111. 
"     French,  112. 
"    Russian,  111. 
"    not  as  good  as  chairs,  135. 
"    of  the  trenches,   62,   64, 

66. 

American  bread  rations,  30. 
"    beef,  33. 
"    desiccated  veg.,  35. 
Amputations  at  joints,  90. 

"     experiments    deprecated, 

89. 

«     faulty,  89,  248. 
former  practices,  89. 
immediate  or  delayed,  90, 

92. 

low  as  possible,  89. 
partial,  99. 
rules  for,  88,  99. 
spontaneous,  98, 100,  224, 

225,  226,  227-.      . 
statistics  of,  213,214,  215. 
sub-malleolar,  89. 
thigh,  92. 
Antiscorbutics,  35,  36,  39,  60,  180, 

189. 

Apothecaries,  French  army,  66. 
Arabas,  26,  51,  124,  127,  150. 
Arms  of  precision,  78. 


Army  of  Potomac,  sickness  in,  142. 
Aromatic  fumigations,  170,  172. 
Attendants    from    convalescents, 
176. 


Baidar,  14,  17,  19,  20,  25,  26,  32, 

33,  46,  56,  163. 
Bailly,  Dr.,  124. 
Bakeries,  camp,  30,  56. 
Balaclava,  14,  15,  16,  17.  20,  21, 

35,  73,  76,  192,  196,  251. 
Balls,  conical,  78,  79. 

"    in  wounds,  82. 

"    (see  Gunshot  Wounds,) 
Bandages,  68,  78. 
Barracks,  28,  50,  58,  169. 
Baths  of  Agamemnon,  11. 
Battle,  Alma,  135. 

"     Balaclava.  20. 

<l    Inkermann,  16,  18,  19. 

"     Traktir,  18,  19. 
Baudens',  M.,  fracture  box,  91,  92, 

215-223. 

"    report  to  Minister,  248. 
Beaujon  hospital,  252. 
Beds  and  bedding,  49,  50,  59,  68, 

172,  185,  241. 
Beef,  31,  33,  41,  110,  205. 
Beer,  75. 

Birds  of  prey,  65,  125. 
Biscuit,  29,  30,  59. 
Bivouac  before  voyage,  192. 
Blankets,  52,  59,  68,  185,  241. 
Bolting  of  flour,  81. 
Bombs,  wounds  by,  87. 
Bones,  use  of,  31,  32. 
Boots,  23,  54,  55,  141. 
Bowel  complaints,  English,  140, 
12* 


254 


INDEX. 


Brandy,  37,  38,  59,  75. 

Bread,  '27,   30,    31,    40,    59.    75, 

115. 

Breakfast  for  troops,  40. 
Bronchitis,  51,  53,  151. 
Building  materials,  50,  51,  58. 
Burden  of  a  soldier,  55. 

Cabbage,  34,  205. 

Cacolets,  135. 

Calchi,    hosp.    island,    200,    244, 

247. 

Callosity  of  fractures,  92. 
Camels  for  carrying  wounded,  135. 
Camp,  25,  43. 

"     of  8 1st  Line,  49. 

"    change  of,  44,  57,  185.  192, 
198. 

"     fires,  46,  47. 

"     Russian,  47,  107. 
Castle  hospital,  73. 
Catarrh.  47. 
Cautery  in  hospital  gangrene,  95, 

96. 

Cavalry  cantonment,  21. 
Cemetery,  army,  44,  65. 

"    Sebastopol,  22. 

"     Turkish.  119. 
Champaigne,  75. 
Chapel,  head-quarters,  26. 

"     hospital,  proposed,  65. 
Chicory,  110,  205. 
Chlorine,   44,   63,    170,   172,  173, 

181,  185..  190,  203. 
Chloroform,  104,  105,  106. 
Chocolate,  68. 

Cholera.  10,  11,  27,  43,  121,  123. 
124,  125,  126,  127,  128, 
129,  145,  180,  244. 

"     English  loss  by,  197. 

u    propagation  of,  131. 

"     symptoms,  134. 

"    theories,  129. 

"    treatment,  130,  131. 

"     unlike  typhus  in  attack,  175. 
Cleanliness,  123. 

"     English,  45. 
Climate  of  Crimea.  25. 
CJocheton  hosp.,  64. 
Clothing,  51,  58. 


Coffee,  38,  59. 

Cold,  action  of.  in  inflammation, 

84,  85. 
Communications,  friendly,  17,  18, 

23,  195. 

Compresses,  68,  78. 
Condiments,  60. 

Conservative  work  of  nature,  99. 
Constantinople  camps,  43,  162. 
"    citizens     escape    typhus, 

201. 

"     convalescent  depot,  164. 

'•     hospitals,  28,  32,  43,  45, 

71,   72,    107,    118,  119, 

131,134,  138,  170,  174, 

203,  204,  205.  213.  214, 

218,  227,  22a  235^  249. 

"     resources  at,   28,    29,  35, 

171. 
"     sanitary      condition,    56, 

164,  180,  188,  228. 
"    school  of  medicine,  111, 

202. 

"     scurvy  in,  199. 
"     sick  sent  to,  28,  63,  112, 
115,  119,  132.  137,  144, 
161,  162,  241,  242. 
"     surgery,  90,  91,  100. 
"     typhus,  165.  166.  167, 168, 
172,  176,  178.' 181,  182, 
183,  184,  188,189,  190, 
191,  199,  201,  242,  243, 
244. 
Contusions,     treated     with     ice, 

86. 

Convalescent  depot,  28,  164. 
"     attendants,  176,  178. 
"     camps,  234,  237. 
Cooking,  35,  36,  37. 
Cotton  for  dressings,  68,  210. 
Council  of  health,  187,  210,  252. 

"     on  typhus,  172. 
Councils,  medical,  101,  102. 
Crimeenne,  garment,   51,  52,  53, 

58. 

Crowding,  how  understood,  165, 
166. 

Danube,  124,  125,  129. 

"     army  of  the.  in  1829,  76. 


INDEX. 


255 


Daoud-Pacha,  118,  137,  138,  236, 

237,  248. 

Depot.  Maslak,  rules,  137,  234. 
Descartes,  steamer,  14. 
Desiccated  vegetables,  34,  35. 
Diarrhoea,  33,  53,  58,  82,  121,  ISO, 

138,  139,  140,  150,  228,  231. 
Diet  drinks,  139. 

"     hospital,  205,  211. 
Digestion,  theory  of,  34. 
Dilatation    of   conical    balls,    79, 

80. 

Disarticulation,  90,  92. 
Discipline  promotes  health,  189. 
Disinfectants,  44,  63,  173,  181. 
Dislocations  treated  with  ice,  86. 
Distortions  cured  by  use  of  appa- 
ratus,  218,  219,   220,  221,  222, 

223. 
Dobrutcha,    121,    122,    123,    124, 

125/127,  129,  131,  143. 
Dolma  Batche,  136,  236. 
Drainage  of  camps,  49. 
Dramatic  entertainments,  195, 196. 
Dumas  on  digestion,  34. 
Duvoir,  Leon,  ventilation,  252. 
Dysentery,   27,   38,  53,  139,  172, 

197,  228. 

Economy  often  pernicious,  42. 
Edinburgh,  typhus  at,  155. 
Egyptian  troops.  109. 
Electric  wires,  24,  26. 
Embarkation  of  troops.  134,  199. 
English  careful  of  soldiers,  196. 

"    losses  by  war,  197. 

"     sickness,  bulletin  of,  198. 
Epidemics  of  the  Crimea,  113. 
Erysipelas,  252. 
Eupatoria,  15,  108,  109,  121,  147, 

151,  175,  233,  250. 
Expenses  of  a  company,  monthly, 

42. 

Explosion  of  magazines,  69. 
Extemporised  dressings,  103. 
Extraction  of  balls,  83. 

Fatalism  concerning  typhus,  192. 
Felchers,  77,  78. 
Fetes,  military,  195. 


Fevers,  228. 

Crimean,  141,  198. 
intermittent,    13.    121,   141, 

150. 

remittent,  13,  141,  142,  150. 
typhoid,  40,  41,  46,  56,  170, 

172.  197,  229,  252.' 
"     typhus  (see  Typhus). 
Field  of  the  dead,  143. 
Firemen,  41. 
Fish,  33,  1531 
Flannel  girdle,   53,  58,   131,  133. 

139. 

Food,  29. 

Fortifications  built,  114. 
Fowls,  33,  76. 

Fractures,  apparatus  for,  90,  91, 
92,  216,   217,  218,  219, 
220,  221,  222,  223. 
"    ice,  in  treatment  of,  86. 
Franka,  120,  124,  127. 
Freezing,  96,  97,  98,  224,  225,  226, 

227,  228. 
Fuel,    25,   26,   27,  30,  46,  56,  57, 

133. 

Fumigations,   110,  160,  170,  172, 
181,  203,  239. 

Gaiters,  59,  60. 

Gallipolis,  12,  113,  114,  115,  116, 

118,  123,  l'74,  206,  250. 
Game,  33. 

Gardens,  culinary,  36,  60,  62. 
^Gelatine  of  bones,  32. 
Geology  of  Crimea,  14,  18,  20. 
Grain  raised  by  troops,  50. 
Greaves,  54. 

Grottoes  as  hospitals,  65. 
Gulhane,  172,  173,  2U3,  215,  216, 

217,  224,  225,  236. 

Gunshot  wounds,  80,  81,  82,  83, 
84,   85,  93,  94,   215,  216,  217, 

218,  219,  220,  221,  222. 

Habit,  Russian,  52. 

Harem,  hospital  of,  205. 

Helmet,  fur,  53. 

Haemorrhage   checked  in  disrup- 

ture,  87. 
Hernias  treated  with  ice,  86. 


256 


INDEX. 


Hildebrand  on  typhus,   157,  158, 

161,  184. 

Horses,  Arabian,  195. 
Horse-flesh,  32,  33,  240. 
Hospital,  Adrianople,  116. 

"     artillery  park,  62. 

"    arrangement,  63,  64. 

"     attendants,  186. 

"     Bachistach,  205. 

"     Balaclava,  73. 

"    Balbec,  48. 

"    barracks  for,  67,  70. 

"    Beaujon,  252. 

"    Caulidje,  136. 

"    Castle,  73. 

"     Calchi,  200. 

"     Constantinople  (see  Constan- 
tinople). 

"     convalescent,  106. 

"     Daoud-Pacha,  118,  137,  138, 
168,  236,  237,  247. 

"    Dardanelles,  12. 

"     diet,  68,  74,  110. 

"     Sardinian,  211. 

"    Doltna  Baktche,  136,  236. 

"     division,  65,  66,  68. 

"    English,  11,  12,  70,  73,  74, 
75,  196. 

"    Eupatoria,  109,  110. 

11     field,  27,  28,  62,  63,  64,  65, 
66,  67,  69,  126,  127,  135. 

"    frigate,  196. 

"    Gallipolis,  12,  115,  174,  250. 

"     Gulhane,  90,  137,  203,  215, 
216,  224,  225,  236. 

"     Guyer,  194,  206. 

"     harem,  205. 

**    head-quarters,  26. 

"     Hyeres,  194,  206. 

"    injured  by  explosion,  70 

11     Jeni-Batche,  203. 

"    Kamiesch,  22. 

"     Malta,  10. 

"    Maltepe,  118,  119,  236,  237. 

"     Marseilles,  14. 

"     Maslak,  177,  180,  181,  187. 

"    military   school,    138,    236, 
237. 

"    movements  of,  68,  69,  70. 

"    Navy  office,  203,  205. 


j  Hospital,   overcrowding  perilous, 
108. 
"     Parade-ground,    138,     219, 

220,   221,  222,  223,  236, 

237. 

"     Pera,  143,  144,  236. 
"    Piedmontese,  76. 
"     Pirea,  206. 
"     Prinkipo,  199,  200,  248. 
"    purification  of,  177,  180. 
"     Ramis-Tchefflick,  137,    236, 

237,  248. 
"    register,  64. 
"     Rodosto,  118. 
"     Russian   embassy,  76,  111, 

137,  145. 

"     Saint  George,  74. 
"     St.  Marguerite.  199. 
tt     Sardinian,  74,  75. 
"    Seraskierat,  203. 
"     Sisters  of  Charity,  145. 
"    series  of,   to  France,    206, 

249. 

"     Smyrna,  11. 
"    supplies  to,  68. 
j      "    tents  for,  48,  67,  70,   127, 

128. 
"    trenches,  of  the,  64,  65,  66, 

69. 
"     Turkish,  109,  110,  147,  203, 

204,  205. 

"     University,  137,  236. 
"    Val-de-Grace,  40. 
"     Varna,  121. 
"    Vincennes,  252. 
"    Visited,  174. 
"    washing  for,  68. 
"    gangrene,  12,  13,  27,  43,  86, 

94,   100,    145,    158,   248, 

252. 

"     described,  94,  95. 
"    isolation  required,  95. 
"    treatment,  of,  95,  96. 
Hungary  fever,  155. 
Hunter's  experiments,  85. 
Huts,  46,  56,  58,  73,  74. 
Hygiene,  ignorance  of,  12,  43. 
"     precautions  in,    60,  61,  64, 

193. 
"    statistics  of,  U.  S.,  61. 


INDEX. 


257 


Ice  on  gunshot  wounds,  84,  85,  86. 

"•    theory  of  action  of,  85. 
Imperial  Medical  Society.  202. 
Indians,  survive  greater  injuries. 

144. 

Infirmaries,  62,  63,  64,  67. 
Inflammation  after  wounds,  89. 
Infusions,  medical,  139. 
Inkermann,  16,  17,  61,  73. 
Inspection,  14,  26,  66,  111. 
Instructions  in  case  of  epidemics, 

167. 
Jupiter,  ship,  250. 

Kamiesch,  14,  15,  16,  21,  22,  23, 

33,  57,  192,  196,  198,  250. 
Kearney's  brigade  bakery,  30. 
Kidney  beans,  36. 
Knapsacks,  55. 
Kustendje,  124,  125,  126. 

Labor  promotes  health,  41,  42. 
Laborers,  English,  41. 

"     French,  habits  of,  41. 

"     in  Algeria,  42. 
Land,  32,  59. 
Larrey,  writings  of,  103. 
Lazarettos  as  hospitals,  10,  12. 
Lemons,  60,  153. 

"    juice,  36,  39,  189. 
Lentils,  36. 

Letters,   M.    Angot  to  Baudens, 
164. 

"    Baudens  to  Marshal  Pelis- 
sier,  168,  177.  189,  207. 

41     to  Minister  of  War,  27,  55, 
174,  181,  193. 

"    Council  of  Health  to  Bau- 
dens, 187. 

"     Intendant  to  Baudens,  186. 
Liebig  on  digestion,  34. 
Ligature     of    arteries,    statistics, 

214. 

Lime  water,  44,  62,  185. 
Linen  for  dressings,  68,  209,  210. 
Lisfranc  on  wounds,  82. 
Macadamized  roads,  25. 
Macleod,  Dr.,  90,  106,  140,  214. 
Magendie  on  varied  food,  40. 
Mahommedan  indolence,  114. 


Malarious  influences,  142,  143. 
Maltepe,  119,  171,  236,  237. 
Mangalia,  123,  125,  126,  127. 
Marcet,  Dr.,  report,  244,  247. 
Marching  orders,  Gen.  Bugeaud, 

132. 
Marseilles,  14,   28,  99,  179,  183, 

184,  186,  194,  201,  205. 
Mascara  expedition,  38,  135,  215. 
Maslak,   119,   138,  145,  161,  171, 

180,  181,   187,    228,    229,  235, 

236,  237. 
Mayence,  fever,   155,  161 ;  siege, 

175. 

Meals,    number    should    be    in- 
creased, 39. 
Meat,  horse,  32,  33,  240. 

"    powdered,  32,  240. 

"     preserved,  32,  59,  240. 
Medical  education,  Turkish,  201. 
"  "  Russian,  77. 

"     society  founded,  202. 
Messina,  206,  249. 
Mexican  war  statistics,  61. 
Miasms,  15,  43,  44. 

"     fevers  from,  141. 
Military  school  hospital,  138,  236, 

237. 
Milk  concentrated,  27,  68. 

"     fresh,  on  ship  board,  196. 
Mines  and  minerals,  153. 
Minie  balls,  78. 
Morale  of  troops,  208. 
Mutton,  32,  110,  205. 
Mytilene,  151,  152,  153,  154,  171, 

200. 

Naples  fever,  155. 
Navarin,  ship,  250. 
Negligence,  French  soldiers,  45, 

63. 

Nervous  prostration,  104. 
Nightingale.  Miss,  74. 
Nitrogenous  foods,  34. 
Nostalgia,  28. 
Nurses,  female,  76,  77. 

Offal,  disposal  of,  60. 
Onions,  60. 
Ortinoque,  ship,  245. 


258 


INDEX. 


Parade  ground,  hosps.,  138,  173, 
219,  220,  221,  222,  223,  236, 
237. 

Paris,  bakeries,  30. 

"     medical  schools,  111,  147. 

Patriotism,  Russian,  150. 

Pera,  137, 138,  143,  145,  146, 173, 
183,  236. 

Percy,  quoted,  103,  184. 

Perforations  of  foot,  by  balls,  94. 

Periosteum  generates  bone,  93. 

Peritonitis,  228. 

Peyer's  glands,  diseased  in  ty- 
phoid, 232. 

Pharmaceutical  department,  138. 

Philadelphia,  typhus  at,  155. 

Phthisis  pulmonalis,  41,  205. 

Physicians  (see  Surgeons). 

Piedmontese,  19,  "20,  46,  76,  21]. 

Pirates,  haunts  of,  20. 

Pits  for  huts,  14,  15,  46,  47,  56, 
57. 

Plague,  1792,  174. 
1829,  76. 

Pleurisy,  262. 

Pneumonia,  53,  150. 

Police,  25,  146. 

Policnity,   153. 

Poucharra  arms,  79. 

Port-Vendres,  sick  at,  179. 

Posen,  typhus  at,  155. 

Potatoes,  33,  50,  60  75,  153. 

Preparations  for  sickness,  1 68. 

Preserved  vegetables,  27,  33,  34. 

Prinkipo,  Island,  187,  199,  200, 
248,  249. 

Proximate  principles,  34. 

Puddings,  74. 

Quarantine,  194,  200,  205,  249. 
Quarries,  23. 

Quindros  thermal  spring,  152, 153. 
Quinine,  use  of,  142. 

Radishes,  60. 

Ramis-Tchifflick,    118,    171,    174, 

236,  237,  248. 
Rations,  hospital,  211. 

"     English,  39. 

"     French,  29,  39,  41,  145. 


Records,  statistical,  164. 

Regimental  fund,  30. 

Resection,  92,   93,   94,  213,    214, 

215. 

Resources  of  the  Crimea,  25. 
Return  of  army,  195,  205,  249. 
Rewards  for  preserving  horses,  37, 

50,  59,  68. 
Rheumatism,  46,  47. 
Rice,  205. 
Rifled  arms,  79,  80. 
Rifles,  Russian,  79. 
Rum,  75. 
Russian  embassy,  145. 

"     prisoners,  vitality  of,  144. 

Sac  formed  around  balls,  83. 

St.  Cloud  barracks,  252. 

St.  George,  monastery,  14,  21,  28, 

73,  198Y 

St.  Omer,  sickness  at,  37,  41. 
Sanitary  condition,  56,  189. 
Sardinian  hospitals,  75,  211. 

"     troops,  20,  195. 
Sausage,  32. 

Scarcity  produces  sickness,  40. 
Scenery,  Sebastopol,  106. 
School  of  Medicine,  Turkish,  201. 
Scorbutic  taint,  140,  150,  170. 
Scrive,  M.,  71,  102,  106,  161,  162, 

163,  179,  199,  242. 
Scultet,  apparatus  of,  222,  223. 
Scurvy,  13,  20,  27,  35,  40,  41,  47, 
50,  56,  60,  76,  109,  146, 
148,  149,  158,   180,   199, 
200,  228,  248. 
causes,  148. 
epidemic,  150, 
English  army,  150. 
Russian  army  exempt,  150. 
symptoms,  148. 
"     treatment,  150,  151. 
"     Turkish  army,  151. 
Scutari,  80,  116,  143,  203,  204. 
Sheepskin  garments,  53,  54. 
Shells,  wounds  by,  86,  88. 
Shelters,  56. 
Shelter-tents,  45,  47,  59,  135, 198, 

239,  251. 
Shirts,  woollen,  53,  54,  59. 


INDEX. 


259 


Shoes,  54,  133. 

Sicily,  hospital  prohibited,  206. 

Sickness,  aggregate  French,  207. 

Sidi-Ferruck,  wounds  at,  81. 

Silistria,  115,  122,  129. 

Sisters  of  Charity,  10,  76, 145,  149, 

186,  229. 
Sisterhood  of  St.  Vincent  de  Paul, 

183. 

Skeletons  of  the  slain,  17. 
Soil  of  Crimea,  14,  15. 
Soldier-dressers,  71,  72,  76. 
Soldiers,  careless  of  health,  121. 
Soup,  40,  58,  60. 
Sour-krout,  36,  60. 
Spencer,  English,  53. 
Splinters  of  bone,  82,  92,  316,  217. 

218,  219,  222. 

Staoueli,  gunshot  wounds  at,  81. 
Stockings,  woollen,  54,  59,  60. 
Strasbourg,  typhus  at.  155. 
Students,  Turkish,  201. 
Surgeons,  allowances  to,  187. 
"    assistants,  72,  73,  76,  77, 

110,  186. 

"     badges  of,  18,  73. 
"     devotion  of,  9, -71,   100, 

101,  171,  176,  207. 
1     died  of  typhus,  182,  233. 
"     discussions  among,    101, 

102. 
"     division  hospitals,  66,  69, 

70. 
"     duties  of  various  grades, 

67. 

"     English,  73,  74,  106 
"     funerals  of,  183. 
"     grades,  French,  71,  72,  77. 
"     losses  of,  179,  182,    188, 

193. 

"     military,  66,  67,  186. 
"     pensions  not  allowed,  183. 
"     promptness        necessary, 

103. 

"     qualifications  of,  102,  103. 
"     quartered  in  hospitals,  70, 

71. 

"     Russian,  77,  78. 
"     Sardinian,  106. 
"     Turkish,  201,  202. 


Surgeons,  wounded,  18. 

Sultan,   116,   118,   143,  146,  147, 

148. 

"     attends  a  ball,  146. 
"     endows  a  medical  society, 

202. 
Surgical  operations,  78. 

Tchernala,  14,  16,  17,  18,  19,  20, 

25,  44,  69,  163,  195,  198. 
Tea,  11,  38,  74. 
Tenedos,  associations  of,  12. 
Tents,  conical,  59,  147. 

"     Crimean,  47. 

"    hospital,  48. 

"    marquee,  or  wall,  48. 

"     shelter,  or  "  Tente-abris." — 
(see  Shelter-Tent.) 

"     ventilation  of,  44. 

"     winter  use  bad,  169. 
Terrassacum,  plant,  35. 
Thiery,  method  of  washing,  136. 
Thouvenin  arms,  79. 
Tige  rifle,  79,  80. 
Tlemcen,  expedition  of,  38. 
Tolerance  of  Turks,  138. 
Topography  of  Crimea,  10,  14,  20. 
Torgau,  typhus  of,  161. 
Tornado,  15. 
Toulon,  sick  at,  155,  179, 183, 186, 

•193,  201,  205. 
Trajan,  camp  of,  124. 
Tunic,  52,  53. 
Turbot,  buckle.  83. 
Turks,  ablutions  of,  45. 
Typhic  condition,  229. 
Typhus,  15,  20,  27,  35,  40,  43,  47, 
71,   74,    76,    138,   140, 
145,  155,  174,  248,  249. 
"     alarm  in  south  of  France, 

205. 

"     Calchi,  245. 
'    Constantinople,    229,    230, 

231,  232,  233. 

"     compared  with  cholera,  175. 
"    convalescence,  159,  232. 
"     course  indefinite,  157. 
"    decline  of,  207. 
"    differs  from  typhoid  fever, 

232,  233. 


260 


INDEX. 


Typhus,    disencumberment,    177, 

180,  181,  187,  190,  201. 
"     English',  196,  198. 
"    history  and  origin,  155,  156, 

238. 

"    limited  to  hospitals,  179. 
"    Marseilles,  194. 
"    not  to  be  sent  off,  184,  242. 
"    nurses  die  of,  183. 
"    officers  escape,  171. 
"    premonitions  of,   158,  238, 

246. 
"     prevention,  167,  172,   174, 

238. 
"    progress  of,  157,  158,  159, 

165,  166,  168,  171,  177, 

181,  184,  186,  189,  190, 

191,  199,  242. 
"    removal  of  causes,  192. 
"     reports  on,  177,  237,   243, 

244,  245. 

"    should  be  kept  in  the  Cri- 
mea. 177,  186,  188. 
"    sent  to' France,  183, 
"     sent  to  camp,  182. 
11     ship-board,   184,  192,    194, 

200,  201,   246,  247,  250. 
"    surgeons  die  of,   171,   182, 

183. 
"     symptoms,    155-158,  230, 

231,  238,  246,  247. 
"     synonyms,  155. 
"     treatment    of,     160,    191, 

247. 


Undeveloped  disease,   140. 
University  hospital,  236. 
Utah,  troops  in,  35,  48. 

Val-de-Grace,  86,  103,  124. 
Varna,  26,  57,  109,  116,  117,  118, 

120,  122,    124,   125,    126,    127, 

128,  151,  180. 
Vegetables,    fresh,    35,    50,    60, 

241. 

Ventilation,  necessity  proved,  251. 
"       of  camps,  44,  47,  49,  56, 
57,  160, 185,  190,  239. 
Vincennes  mil.  hosp.,  252. 

Washing,  68,  138,  173,  204,  209, 

210. 
Wind  of  Crimea,  15,  25,  44. 

"    of  a  ball  (so  called),  88. 
Wine,  11,  37,  74,  115,  139,  153, 

181,  212. 

Winter  quarters,  26,  29. 
Wooden  shoes,  54,  59. 
Woollen  under  clothing,   53,   54, 

59. 
Wounds,  battle  of  Alma,  135. 

"    Inkermann,  16. 
"     Traktir,  19. 
siege,  24,  65,  66,  68,  69. 
shell,  80,  81,  86. 
gunshot,  80. 
Wr  nging  machine,  204. 

Zouaves,  costume  of,  52,  118. 


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